| Peer-Reviewed

The Challenge of Radiological Evaluation of T4 Breast Cancer During Neoadjuvant Chemotherapy in a Resource-Limited Country

Received: 28 August 2022     Accepted: 15 September 2022     Published: 28 September 2022
Views:       Downloads:
Abstract

Locally advanced breast cancer, including Tumor-Node-Metastasis (TNM) stage T4, is the most frequently diagnosed cancer in Burkina Faso. Breast imaging is essential in the initial assessment and evaluation of the response of breast cancers under neoadjuvant chemotherapy (NAC). A therapeutic challenge is posed by the poverty of the population, aiming to rationalise paraclinical explorations, particularly medical imaging. We conducted this study to discuss relevant imaging strategies for the evaluation of tumour response in advanced breast cancer during neoadjuvant chemotherapy in our context of resource-limited countries. It was a cross-sectional descriptive study based on the medical records of patients followed up in the oncology department of the Yalgado Ouédraogo University Hospital. All patients treated for T4 non-metastatic breast cancer and who received at least one course of neoadjuvant chemotherapy were included. The study variables were the socio-demographic characteristics of the patients, the initial evaluation (clinical, radiological, anatomopathological); the mid-term and end-of-treatment evaluation of the ANC (clinical, radiological). T4 patients accounted for 74.28% of non-metastatic cancers diagnosed during the study period. The average age was 46 years. There were 96.15% of non-specific invasive carcinomas. Inflammatory type cancers accounted for 66.67% of cases. Lymph node involvement was present in 89.74%. All patients were classified as stage IIIB according to the UICC (Union for International Cancer Control). Initial, mid-term and end-of-treatment clinical assessments of the tumour were performed in 65.38%, 85.5% and 82.98% of cases respectively. Ultrasound was performed only at the initial stage in 51.28% of cases. CT scans were performed in all these evaluations but did not mention tumour size. The tumour response rate was determined empirically. CT would allow, at the same time as the extension assessment, to perform a loco-regional assessment of the breast tumour in the absence of other dedicated breast imaging.

Published in International Journal of Medical Imaging (Volume 10, Issue 3)
DOI 10.11648/j.ijmi.20221003.12
Page(s) 33-38
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Breast Ultrasound, CT Scan, Tumour Response Rate, Burkina Faso

References
[1] Some OR, Ring AH, Konkobo D et al. Breast Cancer in Bobo-Dioulasso, Burkina Faso: Results of Management. 2022; 24 (2): 173-84.
[2] Zongo N, Millogo-Traore imonga FD, Bagre SC, Bagué AH, Ouangre E, Zida M, et al. Place of surgery in the management of breast cancer in women at the Yalgado Ouedraogo University Hospital Center: about 81 cases. Pan Afr. Med. J [Internet]. 2015 [cited 23 August 2022]; 22 (1). Available from: https://www.ajol.info/index.php/pamj/article/view/132961
[3] Marie Ouedraogo NL, Zongo N, Zida M, Sawadogo AY, Sawadogo E, et al. (2018) Breast Cancer in Women Under 40 Years Old at Yalgado Ouedraogo University Hospital (Burkina Faso). J JSM Surg Oncol Res. 2018 3 (1): 1-7.
[4] De Vita Jr. V, Hellman S, Rosenberg SA. Cancer principles and practice of oncology. Ed. Lippincott: Williams &Wilkins, 2008, 3125.
[5] Diéras V, Laurence V, Pierga JY. Neoadjuvant chemotherapy in breast cancer. Letter from Cancer Specialist. 2002; 11 (5): 177-81.
[6] Bouzbid S, Aouras H. Inflammatory breast cancer at the Annaba University Hospital, Algeria. Epidemic Rev. Public Health. 2014; 62: S215-6.
[7] Toure M, Nguessan E, Bambara AT, Kouassi YKK, Dia JML, Adoubi I. Factors related to the late diagnosis of breast cancer in Sub-Saharan Africa: Ivory Coast case. Gynecol Obstet Fertil Senol. 2013; 41 (12): 696-700.
[8] N'Koua-M'Bon JB, Bambara AT, Moukassa D, Gombé-Mbalawa C. Clinical and evolutionary features of inflammatory breast cancers in Brazzaville. Bull Cancer. 2013; 100 (2): 147-53.
[9] Tarpin C, Viens P. Inflammatory breast cancer. In: Namer M, Héry M, Serin D, Spielmann M, Gligorov J, éditeurs. Breast cancer. Paris: Springer; 2007. pp. 393-412.
[10] Feger C, Leconte I, Fellah L. Inflammatory cancers. Journal of Radiology. 2004; 85 (9): 1250.
[11] Ollivier L, Balu–Maestro C, Chapellier C, Leclère J. Imaging evaluation of neoadjuvant breast cancer treatments. Oncology. 2004; 6 (3): 164-8.
[12] Avril N, Sassen S, Roylance R. Response to therapy in breast cancer. J Nucl Med. 2009; 50 Suppl 1: 55S-63S.
[13] Duffaud F, Therasse P. New recommendations for the evaluation of tumor response in solid tumors. Bull Cancer. 2000; 87 (12): 881-6.
[14] V. Feillel, J. P. Alunni, M. H. Marty. Imaging before and after neoadjuvant chemotherapy for breast cancer. The Senologist’s Letter. 2008; 39.
[15] Alunni JP. Inflammatory breast cancer imaging. Journal of Diagnostic and Interventional Radiology. 2012; 93 (2): 103-11.
[16] Mogavero GT, Fishman EK, Kuhlman JE. Inflammatory breast cancer: CT evaluation. Clin Imaging. 1992; 16 (3): 183-6.
[17] Stines J, Troufléau P. Place of imaging in the extension assessment and evaluation of the therapeutic response of breast cancers. 29th Days of the French Society of Senology and Mammary Pathology (SFSPM), Avignon, 14-16 November 2007: advanced breast cancer.
[18] Monzawa S, Washio T, Yasuoka R, Mitsuo M, Kadotani Y, Hanioka K. Incidental detection of clinically unexpected breast lesions by computed tomography. Acta Radiol. 2013; 54 (4): 374-9.
[19] Surov A, Fiedler E, Wienke A, Holzhausen HJ, Spielmann RP, Behrmann C. Intramammary incidental findings on staging computer tomography. Eur J Radiol. 2012; 81 (9): 2174-8.
[20] Al-Katib S, Gupta G, Brudvik A, Ries S, Krauss J, Farah M. A practical guide to managing CT findings in the breast. Clin Imaging. 2020; 60 (2): 274-82.
[21] Cheung YC, Chen SC, Hsieh IC, Lo YF, Tsai HP, Hsueh S, et al. Multidetector computed tomography assessment on tumor size and nodal status in patients with locally advanced breast cancer before and after neoadjuvant chemotherapy. Eur J Surg Oncol. 2006; 32 (10): 1186-90.
Cite This Article
  • APA Style

    Ouedraogo Nina-Astrid, Bambara Augustin Tozoula, Atenguena Okobalemba Etienne, Kabore Bernard, Akanni Faycal, et al. (2022). The Challenge of Radiological Evaluation of T4 Breast Cancer During Neoadjuvant Chemotherapy in a Resource-Limited Country. International Journal of Medical Imaging, 10(3), 33-38. https://doi.org/10.11648/j.ijmi.20221003.12

    Copy | Download

    ACS Style

    Ouedraogo Nina-Astrid; Bambara Augustin Tozoula; Atenguena Okobalemba Etienne; Kabore Bernard; Akanni Faycal, et al. The Challenge of Radiological Evaluation of T4 Breast Cancer During Neoadjuvant Chemotherapy in a Resource-Limited Country. Int. J. Med. Imaging 2022, 10(3), 33-38. doi: 10.11648/j.ijmi.20221003.12

    Copy | Download

    AMA Style

    Ouedraogo Nina-Astrid, Bambara Augustin Tozoula, Atenguena Okobalemba Etienne, Kabore Bernard, Akanni Faycal, et al. The Challenge of Radiological Evaluation of T4 Breast Cancer During Neoadjuvant Chemotherapy in a Resource-Limited Country. Int J Med Imaging. 2022;10(3):33-38. doi: 10.11648/j.ijmi.20221003.12

    Copy | Download

  • @article{10.11648/j.ijmi.20221003.12,
      author = {Ouedraogo Nina-Astrid and Bambara Augustin Tozoula and Atenguena Okobalemba Etienne and Kabore Bernard and Akanni Faycal and Sama Alice Cynthia and Diallo Ousseini and Cisse Rabiou},
      title = {The Challenge of Radiological Evaluation of T4 Breast Cancer During Neoadjuvant Chemotherapy in a Resource-Limited Country},
      journal = {International Journal of Medical Imaging},
      volume = {10},
      number = {3},
      pages = {33-38},
      doi = {10.11648/j.ijmi.20221003.12},
      url = {https://doi.org/10.11648/j.ijmi.20221003.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20221003.12},
      abstract = {Locally advanced breast cancer, including Tumor-Node-Metastasis (TNM) stage T4, is the most frequently diagnosed cancer in Burkina Faso. Breast imaging is essential in the initial assessment and evaluation of the response of breast cancers under neoadjuvant chemotherapy (NAC). A therapeutic challenge is posed by the poverty of the population, aiming to rationalise paraclinical explorations, particularly medical imaging. We conducted this study to discuss relevant imaging strategies for the evaluation of tumour response in advanced breast cancer during neoadjuvant chemotherapy in our context of resource-limited countries. It was a cross-sectional descriptive study based on the medical records of patients followed up in the oncology department of the Yalgado Ouédraogo University Hospital. All patients treated for T4 non-metastatic breast cancer and who received at least one course of neoadjuvant chemotherapy were included. The study variables were the socio-demographic characteristics of the patients, the initial evaluation (clinical, radiological, anatomopathological); the mid-term and end-of-treatment evaluation of the ANC (clinical, radiological). T4 patients accounted for 74.28% of non-metastatic cancers diagnosed during the study period. The average age was 46 years. There were 96.15% of non-specific invasive carcinomas. Inflammatory type cancers accounted for 66.67% of cases. Lymph node involvement was present in 89.74%. All patients were classified as stage IIIB according to the UICC (Union for International Cancer Control). Initial, mid-term and end-of-treatment clinical assessments of the tumour were performed in 65.38%, 85.5% and 82.98% of cases respectively. Ultrasound was performed only at the initial stage in 51.28% of cases. CT scans were performed in all these evaluations but did not mention tumour size. The tumour response rate was determined empirically. CT would allow, at the same time as the extension assessment, to perform a loco-regional assessment of the breast tumour in the absence of other dedicated breast imaging.},
     year = {2022}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - The Challenge of Radiological Evaluation of T4 Breast Cancer During Neoadjuvant Chemotherapy in a Resource-Limited Country
    AU  - Ouedraogo Nina-Astrid
    AU  - Bambara Augustin Tozoula
    AU  - Atenguena Okobalemba Etienne
    AU  - Kabore Bernard
    AU  - Akanni Faycal
    AU  - Sama Alice Cynthia
    AU  - Diallo Ousseini
    AU  - Cisse Rabiou
    Y1  - 2022/09/28
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ijmi.20221003.12
    DO  - 10.11648/j.ijmi.20221003.12
    T2  - International Journal of Medical Imaging
    JF  - International Journal of Medical Imaging
    JO  - International Journal of Medical Imaging
    SP  - 33
    EP  - 38
    PB  - Science Publishing Group
    SN  - 2330-832X
    UR  - https://doi.org/10.11648/j.ijmi.20221003.12
    AB  - Locally advanced breast cancer, including Tumor-Node-Metastasis (TNM) stage T4, is the most frequently diagnosed cancer in Burkina Faso. Breast imaging is essential in the initial assessment and evaluation of the response of breast cancers under neoadjuvant chemotherapy (NAC). A therapeutic challenge is posed by the poverty of the population, aiming to rationalise paraclinical explorations, particularly medical imaging. We conducted this study to discuss relevant imaging strategies for the evaluation of tumour response in advanced breast cancer during neoadjuvant chemotherapy in our context of resource-limited countries. It was a cross-sectional descriptive study based on the medical records of patients followed up in the oncology department of the Yalgado Ouédraogo University Hospital. All patients treated for T4 non-metastatic breast cancer and who received at least one course of neoadjuvant chemotherapy were included. The study variables were the socio-demographic characteristics of the patients, the initial evaluation (clinical, radiological, anatomopathological); the mid-term and end-of-treatment evaluation of the ANC (clinical, radiological). T4 patients accounted for 74.28% of non-metastatic cancers diagnosed during the study period. The average age was 46 years. There were 96.15% of non-specific invasive carcinomas. Inflammatory type cancers accounted for 66.67% of cases. Lymph node involvement was present in 89.74%. All patients were classified as stage IIIB according to the UICC (Union for International Cancer Control). Initial, mid-term and end-of-treatment clinical assessments of the tumour were performed in 65.38%, 85.5% and 82.98% of cases respectively. Ultrasound was performed only at the initial stage in 51.28% of cases. CT scans were performed in all these evaluations but did not mention tumour size. The tumour response rate was determined empirically. CT would allow, at the same time as the extension assessment, to perform a loco-regional assessment of the breast tumour in the absence of other dedicated breast imaging.
    VL  - 10
    IS  - 3
    ER  - 

    Copy | Download

Author Information
  • Laboratory of Radiodiagnosis and Medical Imaging, Training and Research Unit in Health Sciences, Joseph Ki Zerbo University, Ouagadougou, Burkina Faso

  • Laboratory of Non-communicable Diseases, Training and Research Unit in Health Sciences, Joseph Ki Zerbo University, Ouagadougou, Burkina Faso

  • Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroun

  • Department of Cancerology, Yalgado Ouédraogo University Hospital, Ouagadougou, Burkina Faso

  • Department of Cancerology, Yalgado Ouédraogo University Hospital, Ouagadougou, Burkina Faso

  • Department of Cancerology, Yalgado Ouédraogo University Hospital, Ouagadougou, Burkina Faso

  • Laboratory of Radiodiagnosis and Medical Imaging, Training and Research Unit in Health Sciences, Joseph Ki Zerbo University, Ouagadougou, Burkina Faso

  • Laboratory of Radiodiagnosis and Medical Imaging, Training and Research Unit in Health Sciences, Joseph Ki Zerbo University, Ouagadougou, Burkina Faso

  • Sections