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Gramado consensus on imaging evaluation of the response to neoadjuvant systemic therapy for breast cancer
Journal article   Open access   Peer reviewed

Gramado consensus on imaging evaluation of the response to neoadjuvant systemic therapy for breast cancer

Linei Augusta Brolini Delle Urban, Luciano Fernandes Chala, Ivie Braga de Paula, Beatriz Medicis Maranhão Miranda, Almir Galvão Vieira Bitencourt, Paula de Camargo Moraes, Ana Claudia Mendes Rodrigues Mussauer, Carla Cristina Teixeira Polimeni Benetti, Ana Claudia Silveira Racy, Lucio De Carli, …
Radiologia brasileira, Vol.59, e20250101
01/2026
DOI: 10.1590/0100-3984.2025.0101
PMCID: PMC13345094
PMID: 42421849
url
https://pmc.ncbi.nlm.nih.gov/articles/PMC13345094/View
Published (Version of record) Open Access
url
https://doi.org/10.1590/0100-3984.2025.0101View
Published (Version of record) Open Access

Abstract

The assessment of response to neoadjuvant systemic therapy (NST) is a critical pillar in defining the multidisciplinary therapeutic strategy in breast cancer. This consensus aimed to establish national guidelines for imaging assessment of NST, based on the best scientific evidence adapted to the Brazilian context. To this end, a panel of experts was formed, composed of breast radiologists, breast surgeons, oncologists, onco-radiotherapists and breast patholo-gists. The methodology was based on a systematic literature review, followed by face-to-face discussions and rounds of virtual voting (adapted Delphi method), defining consensus when agreement was =75%. As a result, radiological response criteria were standardized, and accuracy, false-negative, and positive rates were determined, as well as the role of mammography, ultrasound, magnetic resonance imaging, and tomosynthesis, stratified by molecular subtypes. Additionally, recommendations were established for marking the breast lesion and axillary lymph nodes before the start of treatment. Finally, the role of other imaging techniques, such as contrast-enhanced mammography and pos-itron-emission tomography/computed tomography, was discussed, as well as the impact of artificial intelligence as tools for evaluating the response to SNRT.
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