Research Roundup for Breast Cancer Awareness Month
Breast cancer awareness month comes around every October. All year long, UCSF imaging scientists and breast radiologists conduct research and clinical trials to improve care for patients with breast cancer. Here we summarize four recent studies.
Epinephrine Reduces Hematoma after Breast Biopsy
Image-guided core-needle breast biopsy (CNBB) is standard in the case of suspicious breast lesions, and symptomatic hematomas such as painful bruising or heavy bleeding can occur at the needle site. Epinephrine-containing lidocaine is often administered for local anesthesia in CNBB to extend the effects, however the epinephrine is thought to also reduce the risk of bleeding complications. Data for this retrospective study came from the six-month national shortage of epinephrine-containing lidocaine (September 1, 2022, to March 15, 2023). During this period, clinics used lidocaine alone, which presented an opportunity for researchers to evaluate the impact on hematoma risk They found that epinephrine-containing lidocaine was associated with lower rates of symptomatic hematomas as well as fewer and smaller mammographically detected hematomas.
Read more in the Journal of Breast Imaging.
Authors: Eric Davis, Sueann Mark, Genevieve Woodard, Felicia Tang, Jessica Hayward, Kimberly Ray, Bonnie Joe, Amie Lee, Maggie Chung, et. al.
MRI Model Identifies Neoadjuvant Chemotherapy Patients for Early Surgery
In a retrospective study using 2010-16 data from the I-SPY 2 trial, UCSF researchers determined that a functional tumor volume (FTV) predictive model can anticipate treatment response in breast cancer patients undergoing neoadjuvant chemotherapy. With data from dynamic contrast-enhanced MRI and biopsy results, the model indicated that patients with excellent responses could proceed to surgery early. This study presents the results of subtype-specific MRI models and probability threshold selection for identifying patients who will respond well to neoadjuvant chemotherapy.
This research was published in Tomography.
Authors: Wen Li, Natsuko Onishi, Jessica Gibbs, Lisa Wilmes, Nu Le, Pouya Mutant, Elissa Price, Bonnie Joe, Nola Hylton, et. al.
Immunotherapy Injection Shrinks Ductal Carcinoma in situ Lesions
This clinical trial tested the safety and efficacy of intratumoral immunotherapy injection (pembrolizumab and mRNA-2752) in patients with high-risk ductal carcinoma in situ (DCIS), a noninvasive breast cancer. The combination was associated with substantial treatment responses. It was feasible, safe, and tolerable, with high response rates. The small-scale clinical trial demonstrated proof of principle that large high-risk DCIS can regress with intratumoral immunotherapy, potentially reducing the lesions sufficiently to allow breast-conserving surgery, sparing patients from mastectomy.
The trial was published in JAMA Oncology.
Authors: Natsuko Onishi, Nola Hylton, et. al.
MRI Underestimates Tumor Size After Neoadjuvant Therapy
This study evaluated the accuracy of post-treatment MRI for invasive lobular carcinoma (ILC), the second most common breast cancer, and examined the impact on surgical outcomes. ILC grows in a diffuse and infiltrating pattern which makes obtaining clear margins after breast-conserving surgery (BCS) a challenge. Researchers found that after neoadjuvant therapy, post-treatment MRI tends to underestimate tumor size more than it overestimates. However, compared with mammography and ultrasonography, MRI assessment of tumor size is more accurate, yet the authors believe surgeons should still consider adopting a more aggressive resection strategy during BCS to account for the anticipated size discrepancy.
Read more in Breast Oncology.
Authors include Maggie Chung, Amie Lee, et. al.