Objective To investigate the predictive value of multimodal ultrasound parameters combined with systemic inflammation response index (SIRI) and neutrophil-to-lymphocyte ratio (NLR) for efficacy of neoadjuvant chemotherapy (NAC) in patients with breast cancer (BC).

Methods A total of 132 BC patients in the Provincial Hospital Affiliated to Shandong First Medical University from March 2022 to March 2024 were selected as the study subjects, and they were divided into effective group (n=100) and ineffective group (n=32) according to the NAC results. Multimodal ultrasound parameters, SIRI, and NLR before NAC treatment were compared between the two groups. Multivariate Logistic regression analysis was used to explore the influencing factors of ineffective NAC in BC patients.

Results After NAC treatment, among 132 BC patients, 23 cases achieved complete remission, 77 cases achieved partial remission, 29 cases had stable disease, and 3 cases had disease progression. The elasticity score and resistance index (RI) in the effective group were significantly lower than those in the ineffective group, while the peak intensity (PI), area under the curve (AUC), and peak systolic velocity (PSV) were significantly higher than those in the ineffective group (P < 0.05). The neutrophil count and monocyte count in the ineffective group were significantly higher than those in the effective group, while the lymphocyte count was significantly lower than that in the effectivegroup (P < 0.05). Before NAC treatment, the SIRI and NLR in the ineffective group were significantly higher than those in the effective group (P < 0.05). The proportions of patients with non-triple-negative breast cancer and lymph node metastasis in the ineffective group were significantly higher than those in the effective group (P < 0.05). Multivariate Logistic regression analysis showed that high RI, high SIRI, high NLR, high elasticity score, low PSV, low PI, low AUC, non-triple-negative breast cancer, and lymph node metastasis were risk factors for ineffective NAC in BC patients (P < 0.05). Receiver operating characteristic (ROC) curve analysis showed that the AUC for predicting the efficacy of NAC in BC by the combination of multimodalultrasound parameters, SIRI, and NLR was 0.929, which was significantly higher than that of the three independent predictors alone (P < 0.05).

Conclusion The combination of multimodal ultrasound parameters, SIRI, and NLR has a high predictive value for the efficacy of NAC in BC and may serve as effective predictors for the efficacy of NAC.