title: Association between mammographic features and response to neoadjuvant chemotherapy in locally advanced breast carcinoma.
abstract: OBJECTIVE
  Mammography is the cornerstone of breast cancer (BC) evaluation. This report investigates whether breast density (BD) and mammographic features of the tumor can provide information on both BC susceptibility to chemotherapy and other clinicopathologic features of locally advanced BC (LA BC).
  
  
  METHODS
  We evaluated mammography films and clinicopathological information of patients with LA BC who received neoadjuvant chemotherapy (NAC) followed by tumor resection at the Instituto Nacional de Enfermedades Neoplásicas (INEN) from 2000 to 2011.
  
  
  RESULTS
  We selected 494 LA BC cases. Most cases were at clinical tumor stage 4 (48.5%), node stage 1 (58.8%) and had high histologic grade (53.3%). BI-RADS 1, 2, 3, and 4 BD were found in 16.9%, 22%, 35.7% and 25.1% of patients, respectively. High BD has been associated with younger age (p<0.001), obesity (p=0.017) and no skin infiltration (T3 vs T4) (p=0.018). An association between dusty microcalcifications and HER2 group, as well as between casting microcalcifications and TN BC group (p=0.05) was found. NAC included anthracyclines and taxanes in 422 (85.5%) cases. Miller-Payne pathologic responses 4 and 5 (pCR) in the primary lesion and absence of axillary lymph nodes involvement were found in 15.3% of cases and were associated with younger age (p<0.001) and HG-3 lesions (p<0.001), but not with mammographic images.
  
  
  CONCLUSIONS
  Mammographic features are associated with specific clinicopathological features of pre-NAC BC lesions but do not predict pCR. The implications and biological reasons for these findings require further study.
authors.affiliation: Instituto Nacional de Enfermedades Neoplasicas, Medical Oncology Department, Av. Angamos Este, 2520 Surquillo, Lima, Peru. Electronic address: carloscastanedaaltamirano@yahoo.com.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Castaneda
authors.affiliation: Instituto Nacional de Enfermedades Neoplasicas, Radiology Department, Av. Angamos Este, 2520 Surquillo, Lima, Peru.
authors.forename: Raymundo
authors.initials: R
authors.lastname: Flores
authors.affiliation: Instituto Nacional de Enfermedades Neoplasicas, Medical Oncology Department, Av. Angamos Este, 2520 Surquillo, Lima, Peru.
authors.forename: Katerin
authors.initials: K
authors.lastname: Rojas
authors.affiliation: Oncosalud- AUNA, Av. Guardia Civil 571, San Borja, Lima, Peru.
authors.forename: Claudio
authors.initials: C
authors.lastname: Flores
authors.affiliation: Instituto Nacional de Enfermedades Neoplasicas, Research Department, Av. Angamos Este, 2520 Surquillo, Lima, Peru.
authors.forename: Miluska
authors.initials: M
authors.lastname: Castillo
authors.affiliation: Instituto Nacional de Enfermedades Neoplasicas, Pathology Department. Av. Angamos Este, 2520 Surquillo, Lima, Peru.
authors.forename: Esperanza
authors.initials: E
authors.lastname: Milla
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human
keywords: Breast; Density; Microcalcification; Neoadjuvant; Pathologic; Response