Diffuse Optical Tomography (DOT) for Monitoring Response to Neoadjuvant (Preoperative) Chemotherapy in Breast Cancer

Diffuse Optical Tomography (DOT) for Monitoring Response to Neoadjuvant (Preoperative) Chemotherapy in Breast Cancer

The aim of the study is to determine if DOT can detect response early in breast cancer patients undergoing neoadjuvant chemotherapy.

The pilot study will enrol up to ten patients over one year. Patients receiving neoadjuvant chemotherapy for breast cancer will undergo baseline clinical examination, mammography, ultrasound, MRI and DOT before commencement of treatment. DOT will be repeated at 1,3,6 weeks after chemotherapy, and at the end of each chemotherapy regimen. Ultrasound will be repeated every 6 weeks and at the end of treatment. Mammography and MRI will be repeated once at the end of treatment before surgery. A breast pathologist will evaluate the subtype of breast cancer and the pathologic response of the operative specimen at the end of treatment. Patient satisfaction questionnaires will be administered to evaluate their preferences for DOT, ultrasound, mammography and MRI scanning at the beginning and the end of the study.

Inclusion Criteria:

• Patients receiving neoadjuvant chemotherapy for breast cancer.
• Patients with locally advanced breast tumours or large operable tumours who require neoadjuvant treatment for downstaging.
• Histological confirmation of invasive breast carcinoma.
• Patients with metastatic disease may be eligible if they have oligometastatic disease and breast surgery after neoadjuvant chemotherapy is planned.
• Signed informed consent
• Age equal to or more than 21 years
• Life expectancy greater than 12 weeks.
• ECOG performance status 0-2

Exclusion Criteria:

• Fungating or ulcerated tumours
• Inability to provide informed consent
• Anticipated inability to follow-up patient for response to chemotherapy
• Any contraindication to undergoing ultrasound, MRI, MMG or DOT