Value of ultrasound in predicting pathological complete response of breast cancer after neoadjuvant chemotherapy / 中华超声影像学杂志

ABSTRACT

Objective:To investigate the value of ultrasound in predicting pathological complete response(PCR) of breast cancer patients after neoadjuvant chemotherapy(NAC).Methods:A retrospective analysis was performed in 125 patients(127 breast cancer masses) who underwent NAC in General Hospital of Eastern Theater Command from January 2014 to December 2020. All patients underwent ultrasound examination before and after NAC. The patients were divided into PCR group and non-pathological complete response(NPCR) group according to the postoperative pathological results. The differences of ultrasound parameters between the PCR group and NPCR group before NAC were compared, and Logistic regression was used to analyze the independent predictive factors of PCR. The ROC curve was plotted to evaluate the diagnostic efficacy in predicting PCR.Results:Before NAC, the longest diameter of breast cancer in the PCR group was smaller than that in the NPCR group ( P<0.05). There were significant differences in tumor shape, boundary, angulation/crab foot sign, and lateral acoustic shadowing between the two groups (all P<0.05). Logistic regression analysis showed that the longest tumor diameter, clear boundary, and lateral acoustic shadowing were independent predictors of PCR( OR=0.935, 0.321, 5.710, all P<0.05). The area under curve(AUC) of PCR was 0.810 (95% CI=0.731-0.874), the sensitivity and specificity were 61.8% and 88.2% respectively. Conclusions:The longest tumor diameter, boundary, and lateral acoustic shadow assessed by ultrasound are independent predictors of PCR. The combination of the three parameters can provide imaging references for the clinical treatment of breast cancer.