Case Control Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2024; 12(23): 5320-5328
Published online Aug 16, 2024. doi: 10.12998/wjcc.v12.i23.5320
Correlation and predictive value of pathological complete response and ultrasound characteristic parameters in neoadjuvant chemotherapy for breast
Lei Zheng, Li-Xian Yang, Jing-Yi Liu, Zhe Jiang, Xiao-Wei Li, Peng-Peng Pu
Lei Zheng, Li-Xian Yang, Jing-Yi Liu, Xiao-Wei Li, Peng-Peng Pu, Department of Breast Surgery, Xingtai People's Hospital, Xingtai 054001, Hebei Province, China
Zhe Jiang, Department of Medical Imaging, Xingtai People´s Hospital, Xingtai 054001, Hebei Province, China
Author contributions: Zheng L, Yang LX, and Liu JY were the guarantors of the integrity of the entire study; Pu PP and Zheng L conceived the study and design; Yang LX and Jiang Z performed the literature search; Li XW and Pu PP conducted the study; Zheng L and Yang LX conducted the statistical analyses; Zheng L, Liu JY, and Pu PP wrote the manuscript; All authors have access to the data and played a role in writing the manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Xingtai People's Hospital.
Informed consent statement: As this study was retrospective, no patient informed consent was required.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: Data for this study can be obtained from the corresponding authors.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
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: Lei Zheng, MM, Researcher, Department of Breast Surgery, Xingtai People's Hospital, No. 16 Hongxing Street, Qiaodong District, Xingtai 054001, Hebei Province, China. zlys6699@163.com
Received: March 10, 2024
Revised: May 12, 2024
Accepted: June 11, 2024
Published online: August 16, 2024
Processing time: 116 Days and 19.2 Hours
Abstract
BACKGROUND

Breast cancer ranks as one of the most prevalent malignant tumors among women, significantly endangering their health and lives. While radical surgery has been a pivotal method for halting disease progression, it alone is insufficient for enhancing the quality of life for patients.

AIM

To investigate the correlation between ultrasound characteristic parameters of breast cancer lesions and clinical efficacy in patients undergoing neoadjuvant chemotherapy (NAC).

METHODS

Employing a case-control study design, this research involved 178 breast cancer patients treated with NAC at our hospital from July 2019 to June 2022. According to the Miller-Payne grading system, the pathological response, i.e. efficacy, of the NAC in the initial breast lesion after NAC was evaluated. Of these, 59 patients achieved a pathological complete response (PCR), while 119 did not (non-PCR group). Ultrasound characteristics prior to NAC were compared between these groups, and the association of various factors with NAC efficacy was analyzed using univariate and multivariate approaches.

RESULTS

In the PCR group, the incidence of posterior echo attenuation, lesion diameter ≥ 2.0 cm, and Alder blood flow grade ≥ II were significantly lower compared to the non-PCR group (P < 0.05). The area under the curve values for predicting NAC efficacy using posterior echo attenuation, lesion diameter, and Alder grade were 0.604, 0.603, and 0.583, respectively. Also, rates of pathological stage II, lymph node metastasis, vascular invasion, and positive Ki-67 expression were significantly lower in the PCR group (P < 0.05). Logistic regression analysis identified posterior echo attenuation, lesion diameter ≥ 2.0 cm, Alder blood flow grade ≥ II, pathological stage III, vascular invasion, and positive Ki-67 expression as independent predictors of poor response to NAC in breast cancer patients (P < 0.05).

CONCLUSION

While ultrasound characteristics such as posterior echo attenuation, lesion diameter ≥ 2.0 cm, and Alder blood flow grade ≥ II exhibit limited predictive value for NAC efficacy, they are significantly associated with poor response to NAC in breast cancer patients.

Keywords: Breast cancer; Ultrasound; Neoadjuvant chemotherapy; Efficacy; Pathological complete response

Core Tip: This study explored the relationship between ultrasound characteristic parameters of breast cancer lesions and clinical efficacy in patients undergoing neoadjuvant chemotherapy (NAC). In all, 59 cases achieved pathological complete response and 119 cases did not. The ultrasound characteristics of the lesions before NAC were compared between both groups of patients, and the relationship between various factors and the efficacy of NAC in breast cancer was explored using univariate and multivariate analyses. In conclusion, the ultrasound characteristics of breast cancer lesions have limited value in predicting NAC efficacy but are closely related to poor outcomes in breast cancer patients undergoing NAC.