• Measurement of Breast Cancer Size
  

We plan to recruit 20 patients who present to the Internal Medicine Breast Cancer Clinic with breast cancer and who after discussion with the consulting surgeon and oncologist have agreed to undergo neoadjuvant chemotherapy or neoadjuvant hormone therapy. After having undergone routine imaging studies as determined by the breast clinic physician, participation in the MBI neoadjuvant study will be offered to these patients. The study coordinator will approach and inform them of the research project. If they are interested in participating, informed consent will be obtained and the patient will be scheduled for the MBI study. The patient's neoadjuvant therapy will be arranged by the consulting oncologist. The MBI study will be scheduled to not delay administration of neoadjuvant therapy and will be done prior to or within 24 hours of adjuvant therapy administration. Various regimens are being used for neoadjuvant chemotherapy, most treatment guidelines including an initial anthracycline-containing regimen. Taxanes add substantial efficacy to some patients and are increasingly being used for patients with node-positive breast cancer. Neoadjuvant hormone therapy is used for selected patients with estrogen receptor (ER)-positive breast cancer. The consulting oncologist will decide which regimen to use in a particular patient, including the possibile enrollment in a trial evaluating different neoadjuvant agents.

The optimal duration of induction chemotherapy has not been established in randomized controlled trials. Limited information from clinical reports suggests that the pace of response to neoadjuvant chemotherapy is variable. Some patients achieve maximal tumor reduction after only one or two cycles, while others require more therapy. Response to neoadjuvant hormone therapy is often assessed at the end of three to four months.

Following neoadjuvant therapy a careful physical examination with measurements to document the extent of residual disease in breast and regional lymph nodes accompanied by repeat imaging studies like mammogram, ultrasound, and MRI are done. At this time, the patient will undergo a follow-up MBI study. Measurements documented in the patients records will be used for analysis.

After completion of neoadjuvant therapy, the patient will usually undergo local therapy consisting of mastectomy or BCT. The pathology report will provide us with the definite size of the remaining tumor.