Accuracy of ultrasonic evaluation of neoadjuvant chemotherapy for breast cancer and analysis of influencing factors

ZHANG Manqi; ZHA Hailing; LIU Xinpei; WANG Jue; CHEN Rui; LI Cuiying

doi:10.7619/jcmp.20220387

Journal of Clinical Medicine in Practice > 2022 > 26(13): 45-49, 54. > DOI: 10.7619/jcmp.20220387

ZHANG Manqi, ZHA Hailing, LIU Xinpei, WANG Jue, CHEN Rui, LI Cuiying. Accuracy of ultrasonic evaluation of neoadjuvant chemotherapy for breast cancer and analysis of influencing factors[J]. Journal of Clinical Medicine in Practice, 2022, 26(13): 45-49, 54. DOI: 10.7619/jcmp.20220387

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Accuracy of ultrasonic evaluation of neoadjuvant chemotherapy for breast cancer and analysis of influencing factors

1.
Department of Ultrasound Diagnosis, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029
2.
Department of Breast Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029

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Received Date: February 08, 2022
Available Online: July 01, 2022

Graphical Abstract

Abstract

Abstract

Objective
To judge the accuracy of ultrasound examination in evaluating the efficacy of neoadjuvant chemotherapy (NAC) and the size of residual lesion, and to analyze the factors influencing of accuracy of evaluation.
Methods
A total of 260 patients with invasive breast cancer who underwent NAC were enrolled to calculate the differences between the preoperative maximum tumor diameter measured by ultrasound and the postoperative maximum pathological diameter of all patients, and their correlation and the clinicopathological features influencing the difference between them were analyzed.
Results
Of 260 patients, 78 patients obtained pathological complete response (pCR). The sensitivity, specificity, positive predictive value and negative predictive value of pCR after ultrasound assessment of NAC were 82.1%, 88.4%, 75.3% and 86.3%, respectively. The maximum diameter of the tumor measured by ultrasound after NAC was (19.8±14.3) mm, and the maximum diameter of the residual tumor measured by postoperative pathology was (17.9±16.3) mm. The maximum tumor diameter measured by ultrasound was significantly correlated with the maximum residual tumor diameter measured by postoperative pathology (r=0.721, P < 0.001). Clinicopathological features such as mass margin, posterior echo, calcification, histological grade and ER expression state had significant influence on the consistency of residual lesion size by NAC ultrasound and pathological evaluation (P < 0.05). Ultrasound and histopathological assessment showed a good agreement in evaluating tumor with smooth margin, no change in posterior echo, no calcification in the mass, low histological grade, and negative for ER.
Conclusion
In breast cancer patients with no calcification in the tumor, relatively smooth edge, no change in posterior echo, negative estrogen receptor, and low histological grade, ultrasound evaluation of NAC efficacy have higher accuracy, which can effectively help clinicians accurately determine the surgical scope of breast-preserving patients before surgery and formulate individual diagnosis and treatment plans.
- ultrasound,
- breast cancer,
- neoadjuvant chemotherapy,
- residual lesion,
- accuracy,
- pathological complete response

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References

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