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Preoperative Imaging Assessment and Utility of the Systemic Inflammatory Indices in the Management of Invasive Lobular Carcinoma of the Breast / ANITA HUWS

Swansea University Author: ANITA HUWS

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DOI (Published version): 10.23889/SUthesis.66392

Abstract

The last century has witnessed an evolution in the surgical and oncological management of breast cancer. However, the unique characteristics of lobular carcinoma continue to pose challenges in both the preoperative and adjuvant setting. In the first part of this study, the size of lobular cancer was...

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Published: Swansea, Wales, UK 2024
Institution: Swansea University
Degree level: Doctoral
Degree name: M.D
Supervisor: Morgan, Claire; Lewis, Paul
URI: https://cronfa.swan.ac.uk/Record/cronfa66392
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first_indexed 2024-05-10T19:32:13Z
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spelling v2 66392 2024-05-10 Preoperative Imaging Assessment and Utility of the Systemic Inflammatory Indices in the Management of Invasive Lobular Carcinoma of the Breast a95ed53090a422cd24bec529b93e8c0c ANITA HUWS ANITA HUWS true false 2024-05-10 The last century has witnessed an evolution in the surgical and oncological management of breast cancer. However, the unique characteristics of lobular carcinoma continue to pose challenges in both the preoperative and adjuvant setting. In the first part of this study, the size of lobular cancer was assessed on Digital Breast Tomosynthesis and compared with the standard imaging tool, Magnetic Resonance Imaging, using final pathology as the gold standard measurement. The correlation with sonography was calculated as a secondary analysis. The results found that lobular tumour size estimation on tomosynthesis and sonography has low to moderate correlation with final pathology. Although, there is some agreement with tumour sizes less than 2cm, the need for preoperative MRI remains. The introduction of contrast-enhanced spectral mammography may reduce the need for magnetic resonance imaging in the preoperative assessment of lobular breast cancer. Further investigation will be considered. The second analysis evaluated the potential of systemic peripheral blood ratios as prognostic indicators in the adjuvant setting of node negative early breast cancer, comparing two internationally validated tools, the Nottingham Prognostic Index and Oncotype DX® Recurrence Score, to assess whether the blood ratios may reduce the need for genomic testing in selected cases. The recurrence scores of 495 node negative patients with early breast cancer were compared with the Nottingham Prognostic Index and four systemic inflammatory indices calculated from the preoperative peripheral blood count. Statistical tests of correlation found that there was poor to no correlation with the Oncotype DX® Recurrence Score, the Nottingham Prognostic Index and the systemic inflammatory indices investigated, for both subtypes. The results of this study highlight the need for further work in this field. Lobular cancer has distinct morphomolecular and histomolecular properties that require studies specifically designed to address this. E-Thesis Swansea, Wales, UK Lobular carcinoma of the breast; Preoperative imaging; Adjuvant therapy; Systemic inflammatory indices; 2 5 2024 2024-05-02 10.23889/SUthesis.66392 A selection of third party content is redacted or is partially redacted from this thesis due to copyright restrictions. COLLEGE NANME COLLEGE CODE Swansea University Morgan, Claire; Lewis, Paul Doctoral M.D 2024-05-10T20:52:06.3681753 2024-05-10T20:27:59.9261840 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Biomedical Science ANITA HUWS 1 66392__30329__4e9f557780db4518814885caaacaba29.pdf Huws_Anita_M_MD_Thesis_Final_Redacted.pdf 2024-05-10T20:46:59.0263252 Output 11006429 application/pdf Redacted version - open access true Copyright: The author, Anita M. Huws, 2024. Licensed under the terms of a Creative Commons Attribution-NonCommercial-NoDerivs 4.0 license. Third party content is excluded for use under the license terms. true eng https://creativecommons.org/licenses/by-nc-nd/4.0/
title Preoperative Imaging Assessment and Utility of the Systemic Inflammatory Indices in the Management of Invasive Lobular Carcinoma of the Breast
spellingShingle Preoperative Imaging Assessment and Utility of the Systemic Inflammatory Indices in the Management of Invasive Lobular Carcinoma of the Breast
ANITA HUWS
title_short Preoperative Imaging Assessment and Utility of the Systemic Inflammatory Indices in the Management of Invasive Lobular Carcinoma of the Breast
title_full Preoperative Imaging Assessment and Utility of the Systemic Inflammatory Indices in the Management of Invasive Lobular Carcinoma of the Breast
title_fullStr Preoperative Imaging Assessment and Utility of the Systemic Inflammatory Indices in the Management of Invasive Lobular Carcinoma of the Breast
title_full_unstemmed Preoperative Imaging Assessment and Utility of the Systemic Inflammatory Indices in the Management of Invasive Lobular Carcinoma of the Breast
title_sort Preoperative Imaging Assessment and Utility of the Systemic Inflammatory Indices in the Management of Invasive Lobular Carcinoma of the Breast
author_id_str_mv a95ed53090a422cd24bec529b93e8c0c
author_id_fullname_str_mv a95ed53090a422cd24bec529b93e8c0c_***_ANITA HUWS
author ANITA HUWS
author2 ANITA HUWS
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publishDate 2024
institution Swansea University
doi_str_mv 10.23889/SUthesis.66392
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Biomedical Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Biomedical Science
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description The last century has witnessed an evolution in the surgical and oncological management of breast cancer. However, the unique characteristics of lobular carcinoma continue to pose challenges in both the preoperative and adjuvant setting. In the first part of this study, the size of lobular cancer was assessed on Digital Breast Tomosynthesis and compared with the standard imaging tool, Magnetic Resonance Imaging, using final pathology as the gold standard measurement. The correlation with sonography was calculated as a secondary analysis. The results found that lobular tumour size estimation on tomosynthesis and sonography has low to moderate correlation with final pathology. Although, there is some agreement with tumour sizes less than 2cm, the need for preoperative MRI remains. The introduction of contrast-enhanced spectral mammography may reduce the need for magnetic resonance imaging in the preoperative assessment of lobular breast cancer. Further investigation will be considered. The second analysis evaluated the potential of systemic peripheral blood ratios as prognostic indicators in the adjuvant setting of node negative early breast cancer, comparing two internationally validated tools, the Nottingham Prognostic Index and Oncotype DX® Recurrence Score, to assess whether the blood ratios may reduce the need for genomic testing in selected cases. The recurrence scores of 495 node negative patients with early breast cancer were compared with the Nottingham Prognostic Index and four systemic inflammatory indices calculated from the preoperative peripheral blood count. Statistical tests of correlation found that there was poor to no correlation with the Oncotype DX® Recurrence Score, the Nottingham Prognostic Index and the systemic inflammatory indices investigated, for both subtypes. The results of this study highlight the need for further work in this field. Lobular cancer has distinct morphomolecular and histomolecular properties that require studies specifically designed to address this.
published_date 2024-05-02T20:52:04Z
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score 11.017776

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