Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2022; 10(21): 7293-7301
Published online Jul 26, 2022. doi: 10.12998/wjcc.v10.i21.7293
Preoperative neoadjuvant chemotherapy in patients with breast cancer evaluated using strain ultrasonic elastography
Hong-Yu Pan, Qian Zhang, Wen-Jing Wu, Xia Li
Hong-Yu Pan, Qian Zhang, Wen-Jing Wu, Xia Li, Department of Ultrasound, Wuhan Fourth Hospital; Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China
Author contributions: Pan HY and Li X designed this study; Pan HY wrote the manuscript; Pan HY, Zhang Q, Wu WJ and Li X collected the data; and all authors have read and approve the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Fourth Hospital Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors declare no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xia Li, MD, Technician, Department of Ultrasound, Wuhan Fourth Hospital; Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 66 Xuefu South Road, Wuhan 430000, Hubei Province, China. lixia2021314@163.com
Received: March 15, 2022
Peer-review started: March 15, 2022
First decision: April 13, 2022
Revised: April 25, 2022
Accepted: June 24, 2022
Article in press: June 24, 2022
Published online: July 26, 2022
Processing time: 117 Days and 23.1 Hours
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 (rs = 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

Core Tip: The changes in a malignant tumor should be evaluated to determine the effects of preoperative neoadjuvant chemotherapy in breast cancer. However, conventional ultrasonography is not as sensitive as the current pathological reactivity detection method and may not meet clinical needs in determining the effect of neoadjuvant chemotherapy. A relatively novel method called strain ultrasound elastography was used in 90 patients with breast cancer in this study. It was found to be more effective and sensitive in the evaluation of the effects of neoadjuvant chemotherapy in patients with breast cancer.