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      Evaluating ChatGPT as an adjunct for the multidisciplinary tumor board decision-making in primary breast cancer cases

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          Abstract

          Background

          As the available information about breast cancer is growing every day, the decision-making process for the therapy is getting more complex. ChatGPT as a transformer-based language model possesses the ability to write scientific articles and pass medical exams. But is it able to support the multidisciplinary tumor board (MDT) in the planning of the therapy of patients with breast cancer?

          Material and Methods

          We performed a pilot study on 10 consecutive cases of breast cancer patients discussed in MDT at our department in January 2023. Included were patients with a primary diagnosis of early breast cancer. The recommendation of MDT was compared with the recommendation of the ChatGPT for particular patients and the clinical score of the agreement was calculated.

          Results

          Results showed that ChatGPT provided mostly general answers regarding chemotherapy, breast surgery, radiation therapy, chemotherapy, and antibody therapy. It was able to identify risk factors for hereditary breast cancer and point out the elderly patient indicated for chemotherapy to evaluate the cost/benefit effect. ChatGPT wrongly identified the patient with Her2 1 + and 2 + (FISH negative) as in need of therapy with an antibody and called endocrine therapy “hormonal treatment”.

          Conclusions

          Support of artificial intelligence by finding individualized and personalized therapy for our patients in the time of rapidly expanding amount of information is looking for the ways in the clinical routine. ChatGPT has the potential to find its spot in clinical medicine, but the current version is not able to provide specific recommendations for the therapy of patients with primary breast cancer.

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          Most cited references24

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          Trastuzumab Deruxtecan in Previously Treated HER2-Low Advanced Breast Cancer

          Among breast cancers without human epidermal growth factor receptor 2 (HER2) amplification, overexpression, or both, a large proportion express low levels of HER2 that may be targetable. Currently available HER2-directed therapies have been ineffective in patients with these "HER2-low" cancers.
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            International evaluation of an AI system for breast cancer screening

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              Definition and impact of pathologic complete response on prognosis after neoadjuvant chemotherapy in various intrinsic breast cancer subtypes.

              The exact definition of pathologic complete response (pCR) and its prognostic impact on survival in intrinsic breast cancer subtypes is uncertain. Tumor response at surgery and its association with long-term outcome of 6,377 patients with primary breast cancer receiving neoadjuvant anthracycline-taxane-based chemotherapy in seven randomized trials were analyzed. Disease-free survival (DFS) was significantly superior in patients with no invasive and no in situ residuals in breast or nodes (n = 955) compared with patients with residual ductal carcinoma in situ only (n = 309), no invasive residuals in breast but involved nodes (n = 186), only focal-invasive disease in the breast (n = 478), and gross invasive residual disease (n = 4,449; P < .001). Hazard ratios for DFS comparing patients with or without pCR were lowest when defined as no invasive and no in situ residuals (0.446) and increased monotonously when in situ residuals (0.523), no invasive breast residuals but involved nodes (0.623), and focal-invasive disease (0.727) were included in the definition. pCR was associated with improved DFS in luminal B/human epidermal growth factor receptor 2 (HER2) -negative (P = .005), HER2-positive/nonluminal (P < .001), and triple-negative (P < .001) tumors but not in luminal A (P = .39) or luminal B/HER2-positive (P = .45) breast cancer. pCR in HER2-positive (nonluminal) and triple-negative tumors was associated with excellent prognosis. pCR defined as no invasive and no in situ residuals in breast and nodes can best discriminate between patients with favorable and unfavorable outcomes. Patients with noninvasive or focal-invasive residues or involved lymph nodes should not be considered as having achieved pCR. pCR is a suitable surrogate end point for patients with luminal B/HER2-negative, HER2-positive (nonluminal), and triple-negative disease but not for those with luminal B/HER2-positive or luminal A tumors.
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                Author and article information

                Contributors
                stefanlukacjr@gmail.com
                Journal
                Arch Gynecol Obstet
                Arch Gynecol Obstet
                Archives of Gynecology and Obstetrics
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0932-0067
                1432-0711
                17 July 2023
                17 July 2023
                2023
                : 308
                : 6
                : 1831-1844
                Affiliations
                [1 ]Department of Gynecology and Obstetrics, University Hospital Ulm, ( https://ror.org/05emabm63) Prittwitzstr. 43, 89075 Ulm, Germany
                [2 ]Gynäkologische Gemeinschaftspraxis Freising & Moosburg, Munich, Germany
                Author information
                http://orcid.org/0000-0002-9336-2267
                http://orcid.org/0000-0003-1589-2016
                http://orcid.org/0000-0001-5795-3417
                http://orcid.org/0000-0003-1227-1118
                http://orcid.org/0000-0003-2989-5234
                http://orcid.org/0000-0003-2066-5344
                Article
                7130
                10.1007/s00404-023-07130-5
                10579162
                37458761
                2c9b07d0-f40a-4f19-a7e5-e56d952c367c
                © The Author(s) 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 3 April 2023
                : 27 June 2023
                Funding
                Funded by: Universitätsklinikum Ulm (8941)
                Categories
                Gynecologic Oncology
                Custom metadata
                © Springer-Verlag GmbH Germany, part of Springer Nature 2023

                Obstetrics & Gynecology
                artificial intelligence,breast cancer,multidisciplinary tumor board,chatgpt

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