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首页> 外文期刊>British Journal of Cancer >Comment on ‘Diagnosis of pathological complete response to neoadjuvant chemotherapy in breast cancer by minimal invasive biopsy techniques'
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Comment on ‘Diagnosis of pathological complete response to neoadjuvant chemotherapy in breast cancer by minimal invasive biopsy techniques'

机译：评论“通过微创活检技术诊断乳腺癌对新辅助化疗的病理完全反应”

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Sir , We congratulate the authors on performing this multicentre trial with 164 patients ( Heil et al , 2015 ). One important selection criterion is the initial size of the primary tumor (T size) on imaging – this information did not appear in the manuscript and is of interest. The probability of adequately sampling the initial region of disease by image guidance is likely related to the T size at diagnosis and the size of residual disease on imaging. Do the authors have information on the initial T stage of all patients and the size of residual imaging abnormality at the time of pre-surgical biopsy? This is not the first report regarding the concept of minimally invasive techniques for sampling to assess pathologic complete response in breast cancer ( Clouth et al , 2007 ). The success of moving these studies into the realm of clinical omission of surgery is dependent on exquisite radiologic targeting of the lesion (37% did not have a clip placed at initial biopsy in the current study), adequate sampling with vacuum-assisted biopsy (utilized in the current study in ～30%), and the number of biopsies performed (unknown 55% of cases). At MD Anderson, we have an actively accruing trial using image-guided vacuum-assisted biopsy with fine-needle aspiration and more stringent selection criteria including patients with a 50–70% chance of pathologic eradication of disease after neoadjuvant chemo- and targeted therapy (triple-negative and HER2-amplified breast cancers) ( National Institute of Health, 2015 ).
机译：主席先生，我们祝贺作者对164例患者进行了这项多中心试验（Heil等，2015）。一个重要的选择标准是成像时原发肿瘤的初始大小（T大小）–该信息未出现在手稿中，因此很有意义。通过图像引导对疾病的初始区域进行充分采样的可能性可能与诊断时的T大小以及成像时残留疾病的大小有关。作者是否了解所有患者的初始T期以及术前活检时残留影像学异常的大小？这不是关于微创技术用于评估乳腺癌病理完全反应的概念的首次报道（Clouth等，2007）。将这些研究成功纳入临床手术遗漏领域的成功取决于对病变的精确放射学靶向（当前研究中37％的患者在初次活检时没有放置夹子），真空辅助活检进行了充分采样（已利用）在目前的研究中，约有30％的人），并且进行了活组织检查的次数（未知病例的55％）。在MD Anderson，我们进行了一项积极的临床试验，采用影像引导的真空辅助活检，细针穿刺和更严格的选择标准，包括在新辅助化学疗法和靶向疗法后有50％到70％的疾病能够根除疾病的患者（三阴性和HER2扩增乳腺癌）（美国国立卫生研究院，2015年）。

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