Mammographic assessment of breast density as a tool for predicting the response to neoadjuvant therapy in breast cancer patients

Background and aims. Breast cancer (BC) is the most frequently diagnosed leading cause of cancer-related death among women worldwide. For locally advanced diseases high-risk tumors, neoadjuvant therapy (NAT) treatment choice. Some studies show that mammographic density (MD) tumor margins presence microcalcifications play a prognostic role in BC patients. Hence, objective this retrospective study was to assess if MD could predict response NAT different molecular subtypes patients undergoing at The “Prof. Dr I. Chiricuta” Oncology Institute Cluj-Napoca, Romania (IOCN). Furthermore, association between MD, with clinico-pathological data analyzed.
 Methods. Eighty-four breast treated IOCN were included study. morphological characteristics tumors framed according BIRADS lexicon. or absence also assessed. First, significance associations density, parameters tested Fisher Fisher-Freeman-Halton Exact Test. Next, using multinomial logistic regression, we modelled pathological measured by Miller Payne Residual burden (RCB) systems BI-RADS. Variables having significant univariate tests selected as candidates for multivariable analysis (adjusted model).
 Results. densities significantly associated age (p=0.01), number positive lymph nodes (p=0.037), (p=0.002) combined categories Miller-Payne (p=0.034) RCB (p=0.021). Margins ki67 proliferation index (p=0.029), estrogen receptor (ER) (p=0.007), progesterone (PR) (p=0.019), subtype (p<0.001) clinically observed diagnosis (p=0.019).
 Conclusions. In our cohort, lower had higher odds achieving pCR following NAT, suggesting clinical marker. Larger multicenter are warranted validate value which aid stratification based on their likelihood respond