BACKGROUND Our aim is to study if mammographic density (MD) prior to neoadjuvant chemotherapy is a predictive factor in accomplishing a pathological complete response (pCR) in neoadjuvant-treated breast cancer patients. METHODS Data on all neoadjuvant treated breast cancer patients in Southern Sweden (2005-2016) were retrospectively identified, with patient and tumor characteristics retrieved from their medical charts. Diagnostic mammograms were used to evaluate and score MD as categorized by breast composition with the Breast Imaging-Reporting and Data System (BI-RADS) 5th edition. Logistic regression was used in complete cases to assess the odds ratios (OR) for pCR compared to BI-RADS categories (a vs b-d), adjusting for patient and pre-treatment tumor characteristics. RESULTS A total of 302 patients were included in the study population, of which 57 (18.9%) patients accomplished pCR following neoadjuvant chemotherapy. The number of patients in the BI-RADS category a, b, c, and d were separately 16, 120, 140, and 26, respectively. In comparison to patients with BI-RADS breast composition a, patients with denser breasts had a lower OR of accomplishing pCR: BI-RADS b 0.32 (95%CI 0.07-0.1.5), BI-RADS c 0.30 (95%CI 0.06-1.45), and BI-RADS d 0.06 (95%CI 0.01-0.56). These associations were measured with lower point estimates, but wider confidence interval, in premenopausal patients; OR of accomplishing pCR for BI-RADS d in comparison to BI-RADS a: 0.03 (95%CI 0.00-0.76). CONCLUSIONS The likelihood of accomplishing pCR is indicated to be lower in breast cancer patients with higher MD, which need to be analysed in future studies for improved clinical decision-making regarding neoadjuvant treatment.

中文翻译：

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乳腺钼靶密度是乳腺癌新辅助化疗后病理反应的潜在预测指标。

背景技术我们的目的是研究在新辅助化疗后的乳腺癌患者中，新辅助化疗之前的乳腺密度（MD）是否是实现病理完全缓解（pCR）的预测因素。方法回顾性分析瑞典南部（2005-2016年）所有新辅助治疗的乳腺癌患者的数据，并从他们的医学图表中检索患者和肿瘤特征。诊断乳房X线照片用于按乳房成分报告和数据系统（BI-RADS）第5版对按乳房组成分类的MD进行评估和评分。在完整病例中，采用逻辑回归分析来评估pCR与BI-RADS类别（a vs bd）相比的优势比（OR），并根据患者和治疗前的肿瘤特征进行调整。结果共有302名患者被纳入研究人群，其中57例（18.9％）患者在新辅助化疗后完成了pCR。BI-RADS类别a，b，c和d中的患者人数分别分别为16、120、140和26。与BI-RADS乳房成分为a的患者相比，乳房较密的患者完成pCR的OR较低：BI-RADS b为0.32（95％CI 0.07-0.1.5），BI-RADS c为0.30（95％CI 0.06） -1.45）和BI-RADS d 0.06（95％CI 0.01-0.56）。在绝经前患者中，这些关联的估计值较低，但置信区间较宽；与BI-RADS a相比，完成BI-RADS d的pCR的OR：0.03（95％CI 0.00-0.76）。结论在MD较高的乳腺癌患者中，实现pCR的可能性较低，