Clinical application of ultrasound in evaluating pathologically complete response after neoadjuvant chemotherapy for breast cancer / 中华超声影像学杂志

ABSTRACT

Objective:To investigate the value of ultrasound in evaluating pathologically complete response(pCR) of neoadjuvant chemotherapy(NAC) for breast cancer.Methods:A retrospective analysis was performed in 67 breast cancer patients who received NAC in the Second Affiliated Hospital of Harbin Medical University from January 2018 to December 2019. Ultrasound examination was performed before and after NAC, and two-dimensional, color and elastic images were stored for subsequent analysis. According to the operation pathological results after NAC, the patients were divided into two groups, pCR group and npCR group, using the Miller-Payne criteria as the evaluation criteria. Chi-square test was used to compare the ultrasound characteristics of breast masses in pCR group and npCR group before NAC. The accuracy, sensitivity, specificity, positive predicative value(PPV) and negative predicative value(NPV) of pCR were analyzed using ROC curve. The difference of pCR estimated by ultrasound in different molecular types was also analyzed.Results:①Of the 67 patients, 16 achieved pCR and 51 achieved npCR. Among the 16 pCR patients, 11(68.8%) were evaluated correctly and 5(31.2%) were wrong.Among the 51 npCR patients, 49(96.1%) were evaluated correctly and 2(3.9%) were wrong. ②There was no statistically significant difference between pCR and npCR in ultrasound features of pre-NAC breast masses( P>0.05). ③After the whole process of NAC, the accuracy, sensitivity, specificity, PPV and NPV were 89.6%, 68.8%, 96.1%, 84.6%, and 90.7%, respectively; The area under ROC curve was 0.824. ④The diagnostic efficiency of pCR estimated by ultrasound was higher for Luminal B and HER-2 breast cancer. Conclusions:The accuracy of pCR after NAC evaluated by ultrasound is 89.6%, with different diagnostic efficiency in different molecular types.