Feasibility Analysis Of Mammographic Density In Predicting Efficacy Of Neoadjuvant Chemotherapy

Objective: The advent of neoadjuvant therapy has led to a new understanding of breast cancer treatment,and postoperative pathological evaluation of the presence of residual tumor is closely related to the survival and prognosis of patients.The comprehensiveness and accuracy of pathological assessment also have a great impact on the subsequent treatment.This study comprehensively evaluated the effect of neoadjuvant chemotherapy(NACT)by combining advantages and disadvantages of various pathological evaluation systems,and then discussed the relationship between mammographic density(MD)and NACT effect in breast cancer patients.To determine whether MD can be used as a predictor of breast cancer prevention and treatment response,so as to provide a basis for precise individualized treatment.Methods:The clinicopathologic data of patients diagnosed with breast cancer in the Affiliated Hospital of Southwest Medical University from January2019 to December 2021 and met the inclusion and exclusion criteria of this study were collected.According to the 5th edition of the Breast Imaging-Reporting and Data System,the MD was classified into 4 categories: a,b,c,and d.Based on the pathological evaluation system of Miller-Payne(MP)and residual cancer burden(RCB),the status of residual cancer cells and lymph nodes were included in the analysis to evaluate the pathological changes of breast cancer after NACT.After adjusting the factors affecting MD,the original model(only including MD categories as independent variables),the minimum adjustment model(adding age,body mass index,and menopausal status as independent variables),and the fully adjusted model(further including estrogen receptor,progesterone receptor,human epidermal growth factor receptor2,nuclear-associated antigen,axillary lymph node status at the initial diagnosis,and NACT regimen)were used to analyze the relation between MD and NACT effect.In the 3 models,the MD category a was used as the reference.Results:A total of 287 patients with breast cancer were enrolled in this study.Thirty-eight,76,114,and 59 of whom with MD category a,b,c,and d respectively,and 14,117,82,and 74 of whom with grade 1,2,3,and 4 of NACT effect respectively.No matter in integrated patients or premenopausal patients of whom,as well as no matter what kind of adjustment model analysis results,it was found that the regression coefficient was negative,and with the increase of MD classification,the odds ratio was.Conclusion: From the results of this study,the increase of MD classification may have a negative impact on the effect of NACT.Namely,effect of NACT is poor in integrated patients or premenopausal patients of whom with higher MD.MD can be used as a predictor of NACT effect,so as to guide doctors in the selection and individual management of neoadjuvant therapy,and improve the prognosis of patients.