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Henan’an, China

Groheux D.,Paris West University Nanterre La Defense | Groheux D.,University Paris Diderot | Mankoff D.,University of Pennsylvania | Espie M.,University Paris Diderot | And 2 more authors.
European Journal of Nuclear Medicine and Molecular Imaging | Year: 2016

Early assessment of response to neoadjuvant chemotherapy (NAC) might be helpful in avoiding the toxicity of ineffective chemotherapy and allowing refinement of treatment. We conducted a review of the literature regarding the applicability of 18F-FDG PET/CT to the prediction of an early pathological response in different subgroups of breast cancer. Clinical research in this field has intensified in the last few years. Early studies by various groups have shown the potential of 18F-FDG PET/CT in the early assessment of response to NAC. However, interim PET/CT in breast cancer has not yet gained wide acceptance compared to its use in other settings such as lymphomas. This is in part due to a lack of consensus that early evaluation of response can be used to direct change in therapy in the neoadjuvant breast cancer setting, and only limited data showing that response-adaptive therapy leads to improved outcomes. However, one major element that has hampered the use of 18F-FDG PET/CT in directing neoadjuvant therapy is its evaluation in populations with mixed subtypes of breast cancer. However, major improvements have occurred in recent years. Pilot studies have highlighted the need for considering breast cancer subtype and the type of treatment, and have offered criteria for the use of PET/CT for the early prediction of response in specific settings. 18F-FDG PET/CT has considerable potential for the early prediction of pathological complete response to NAC in aggressive subtypes such as triple-negative or HER2-positive breast cancers. The results of a multicentre trial that used early metabolic response on 18F-FDG PET/CT as a means to select poor responders to adapt neoadjuvant treatment have recently been published. Other trials are ongoing or being planned. © 2016, Springer-Verlag Berlin Heidelberg.


Lehmann-Che J.,AP HP | Lehmann-Che J.,French National Center for Scientific Research | Lehmann-Che J.,University Paris Diderot | Amira-Bouhidel F.,AP HP | And 26 more authors.
British Journal of Cancer | Year: 2011

Background: Immunohistochemistry (IHC) and fluorescent in situ hybridisation (FISH) are currently the most commonly used methods to assess HER2 status. PCR-based assays allow quantitative determination of HER2 amplification (Q-PCR) or overexpression (Q-RT-PCR), but are not routinely used. We evaluated the relevance of Q-RT-PCR for HER2 status determination.Methods: We compared IHC and Q-RT-PCR in 466 breast tumours. In discordant or equivocal cases, five additional methods (IHC with two other antibodies, FISH, silver in situ hybridisation (SISH) and Q-PCR) were combined to determine HER2 status. Two cases with HER2 intra-tumour heterogeneity were further explored by allelic profiles analysis and HUMARA clonality determination after microdissection. Results: We observed 97.3% concordance between Q-RT-PCR and non-equivocal IHC. Twelve out of 466 cases (3%) revealed discordances between the two methods. The power of Q-RT-PCR to predict HER2 status (defined by seven methods) was similar to that of IHC. Although rare, some discordances between techniques might be due to HER2 intra-tumour heterogeneity and we report two examples, one tumour containing two distinct clones, another tumour consisting of HER2 amplified and non-amplified subclones. Conclusion: Q-RT-PCR and IHC are highly concordant methods for HER2 status assessment, and Q-RT-PCR allows a highly reliable quantitative assessment and could be a useful adjunct to IHC. © 2011 Cancer Research UK All rights reserved.


Groheux D.,APHP | Groheux D.,University Paris Diderot | Biard L.,APHP | Giacchetti S.,Breast Diseases Center | And 12 more authors.
Journal of Nuclear Medicine | Year: 2016

Patients with triple-negative breast cancer (TNBC) have poor outcome when pathologic complete response (pCR) is not reached after neoadjuvant chemotherapy. Early prediction would be helpful. We evaluated the association between metabolic response after 2 cycles of neoadjuvant chemotherapy, pCR, and outcome in patients receiving 2 different anthracycline-based regimens (conventional and intensified). Methods: Of 77 consecutive TNBC patients, 23 received EC-D (4 cycles of epirubicin 1 cyclophosphamide followed by 4 cycles of docetaxel at conventional doses) and 55 received a dose-intensified, dose-dense concomitant regimen of epirubicin 1 cyclophosphamide (historically called SIM) for 6 cycles. PET/CT with 18F-FDG was performed at baseline and after 2 cycles of neoadjuvant chemotherapy. The associations between clinical factors, biologic factors, early metabolic change, pCR, and event-free survival (EFS) were examined (log-rank test). Results: Of the 78 patients, 29 (37%) achieved pCR. The change in SUVmax (ΔSUVmax) after 2 cycles was more pronounced in patients who achieved pCR (-72% vs. -42%; P , 0.0001). ΔSUVmax was more pronounced under SIM than under EC-D (-68% vs. -35%, P = 0.009), and there was a trend for a higher pCR rate (44% vs. 22%, P = 0.078). Twenty-two patients relapsed and 10 of them died (median follow-up, 34 mo). pCR was associated with EFS (log-rank, P = 0.001). ΔSUVmax was also significantly associated with EFS both in patients receiving SIM (P = 0.028) and in those receiving EC-D (P = 0.021). The optimal ΔSUVmax for predicting pCR and EFS was, however, specific to the treatment regimen. EFS was not associated with tumor grade (P = 0.98), histologic subtype (P = 0.17), or clinical stage (P = 0.097). Conclusion: Early metabolic change during neoadjuvant chemotherapy can predict pathologic response and EFS in TNBC patients under different chemotherapy regimens. However, the metabolic response varies with the type of chemotherapy. COPYRIGHT © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.


Lehmann-Che J.,Laboratory of Biochemistry | Lehmann-Che J.,French National Center for Scientific Research | Lehmann-Che J.,University Paris Diderot | Hamy A.-S.,Breast Diseases Center | And 25 more authors.
Breast Cancer Research | Year: 2013

Introduction: Molecular apocrine (MA) tumors are estrogen receptor (ER) negative breast cancers characterized by androgen receptor (AR) expression. We analyzed a group of 58 transcriptionally defined MA tumors and proposed a new tool to identify these tumors.Methods: We performed quantitative reverse transcription PCR (qRT-PCR) for ESR1, AR, FOXA1 and AR-related genes, and immunohistochemistry (IHC) for ER, PR, Human Epidermal Growth Factor Receptor 2 (HER2), CK5/6, CK17, EGFR, Ki67, AR, FOXA1 and GCDFP15 and we analyzed clinical features.Results: MA tumors were all characterized by ESR1(-) AR(+) FOXA1(+) and AR-related genes positive mRNA profile. IHC staining on these tumors showed 93% ER(-), only 58% AR(+) and 90% FOXA1(+). 67% and 57% MA tumors were HER2(3+) and GCDFP15(+), respectively. Almost all MA tumors (94%) had the IHC signature HER2(3+) or GCDFP15(+) but none of the 13 control basal-like (BL) tumors did. Clinically, MA tumors were rather aggressive, with poor prognostic factors.Conclusion: MA tumors could be better defined by their qRT-PCR-AR profile than by AR IHC. In addition, we found that HER2 or GCDFP15 protein overexpression is a sensitive and specific tool to differentiate MA from BL in the context of ER negative tumors. A composite molecular and IHC signature could, therefore, help to identify MA tumors in daily practice. © 2013 Lehmann-Che et al.; licensee BioMed Central Ltd.


Guo X.-H.,Breast Diseases Center | Liu H.,Breast Diseases Center | Sun X.-F.,Breast Diseases Center | He Y.-N.,Breast Diseases Center | And 2 more authors.
Tumor | Year: 2012

Objective: To evaluate the value of an 11-gauge stereotactic vacuum-assisted biopsy (SVAB) device for the diagnosis of breast microcalcifications. Methods: The 11-gauge SVAB was performed in 93 patients with microcalcifications in X-ray mammograms. The patients who were diagnosed as having breast cancer, atypical hyperplasia, unclarified breast lesions and imaging-histologic discordance should require surgical excision. The histopathological results of biopsy specimens and postoperative specimens were compared. Results: Of 97 lesions with microcalcifications, 96 (99.0%) calcified tissues were obtained. The pathological results showed that 71 (73.2%) were benign lesions, 19 (19.6%) were malignant lesions, 6 (6.2%) were atypical hyperplasia lesions. Of the 25 patients receiving surgical excision, 2 (2/13, 15.4%) with ductal cancer in situ had a final diagnosis of invasive breast cancer, 1 (1/4, 25.0%) with atypical hyperplasia lesions had a final diagnosis of ductal cancer in situ , 1 with imaging-histologic discordance had a final diagnosis of ductal cancer in situ . Of 71 patiens with a pathological diagnosis of benign lesions, 49 had a median follow-up of 14.5 months, and no obvious abnormalities were observed. The complications of 11-gauge SVAB included vasovagal reactions (1.0%), bleeding (2.1%) and hematoma formation (3.1%). Conclusion: The 11-gauge SVAB is an effective and reliable method with slight side effects for the diagnosis of breast microcalcifications if it is applied appropriately. For the breast lesions diagnosed as having atypical hyperplasia and ductal carcinoma in situ or with imaging-histologic discordance, the surgical biopsy should be performed subsequently. Copyright© 2012 by TUMOR.

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