Preoperative neoadjuvant chemotherapy in patients with breast cancer evaluated using strain ultrasonic elastography

Hong-Yu Pan; Qian Zhang; Wen-Jing Wu; Xia Li

doi:10.12998/wjcc.v10.i21.7293

Preoperative neoadjuvant chemotherapy in patients with breast cancer evaluated using strain ultrasonic elastography

World J Clin Cases. 2022 Jul 26;10(21):7293-7301. doi: 10.12998/wjcc.v10.i21.7293.

Authors

Hong-Yu Pan¹, Qian Zhang¹, Wen-Jing Wu¹, Xia Li²

Affiliations

¹ Department of Ultrasound, Wuhan Fourth Hospital; Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China.
² Department of Ultrasound, Wuhan Fourth Hospital; Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China. lixia2021314@163.com.

Abstract

Background: The incidence of breast cancer in China is increasing while its mortality rate is decreasing. The annual breast cancer incidence in China is 39.2 million, accounting for two-thirds of the urban population. In China, breast cancer is the fifth most common malignant tumor overall and the most common in women, accounting for 17% of female malignant tumors.

Aim: To investigate the accuracy of strain ultrasound elastography (SUE) on the evaluation of preoperative neoadjuvant chemotherapy (NAC) in breast cancer.

Methods: Overall, 90 patients with breast cancer treated at our hospital between January 2018 and February 2019 were selected for this study. The patients received six cycles of NAC with docetaxel, epirubicin, and cyclophosphamide. Surgical treatment was also performed, and pathological reactivity was assessed. The patients were evaluated using conventional ultrasonography and SUE before biopsy. The differences between groups were analyzed to calculate the mean and standard deviation with significance measured using a t-test, while multivariate analysis was performed using logistic regression analysis.

Results: Of the patients analyzed, 20 had a pathological complete remission (pCR) while 70 did not achieve pCR after NAC. The ratio of the elastic strain ratio (SR) and elastic score of 4-5 in patients with pCR were 5.5 ± 1.16 and 15.00%, respectively; these were significantly lower than those in patients without pCR (85%) and significantly higher than in patients without pCR (14%). SR and elastic score 4-5 were independent factors influencing NAC efficacy (OR=0.644, 1.426 and 1.366, respectively, P < 0.05). SR was positively correlated with elasticity score (r_s = 0.411, P < 0.05). The area under the receiver operator characteristic curve of SR and SR combined with elastic score in predicting patients without pCR was 0.822 and 0.891, respectively (P < 0.05).

Conclusion: Strain ultrasonic elastography may be used to evaluate the effects of preoperative NAC in patients with breast cancer.

Keywords: Breast cancer; Curative effect; Neoadjuvant chemotherapy; Strain ultrasonic elastography.