Purpose:

This study's primary objective was to evaluate the changes in optically derived parameters acquired with a diffuse optical tomography breast imaging system (DOTBIS) in the tumor volume of patients with breast carcinoma receiving neoadjuvant chemotherapy (NAC).

Experimental Design:

In this analysis of 105 patients with stage II–III breast cancer, normalized mean values of total hemoglobin (⁠|ctTH{b_N}$|⁠), oxyhemoglobin (⁠|ct{O_2}H{b_N}$|⁠), deoxy-hemoglobin concentration (⁠|ctHH{b_N}$|⁠), water, and oxygen saturation (⁠|St{O_2}_N$|⁠) percentages were collected at different timepoints during NAC and compared with baseline measurements. This report compared changes in these optical biomarkers measured in patients who did not achieve a pathologic complete response (non-pCR) and those with a pCR. Differences regarding molecular subtypes were included for hormone receptor–positive and HER2-negative, HER2-positive, and triple-negative breast cancer.

Results:

At baseline, |ctHH{b_N}$| was higher for pCR tumors (3.97 ± 2.29) compared with non-pCR tumors (3.00 ± 1.72; P = 0.031). At the earliest imaging point after starting therapy, the mean change of |ctHH{b_N}$| compared with baseline (⁠|{\Delta _{TP1}}ctHH{b_N}$|⁠) was statistically significantly higher in non-pCR (1.23 ± 0.67) than in those with a pCR (0.87 ± 0.61; P < 0.0005), and significantly correlated to residual cancer burden classification (r = 0.448; P < 0.0005). |{\Delta _{TP1}}ctHH{b_N}$| combined with HER2 status was proposed as a two-predictor logistic model, with AUC = 0.891; P < 0.0005; and 95% confidence interval, 0.812–0.969.

Conclusions:

This study demonstrates that DOTBIS measured features change over time according to tumor pCR status and may predict early in the NAC treatment course whether a patient is responding to NAC.

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