Value of shear wave elasticity in predicting the efficacy of neoadjuvant chemotherapy in different molecular types
Shasha Yuan1, Hua Shao1, Ziyue Na1
1Harbin Medical University Cancer Hospital, Heilongjiang Province, China.
Purpose:
The purpose of this study was to evaluate the response to neoadjuvant chemotherapy (NAC) of different molecular subtypes of breast cancer using shear wave ultrasound elastography (SWE).
Methods:
Ninety-eight patients with final diagnoses of breast cancer prior to NAC were examined with SWE and B-mode ultrasound. These parameters were compared with the response evaluation criteria in solid tumors (RECIST) index and pathological diagnoses. Then, we recorded the area under the receiver operating characteristic (ROC) curve. Immunohistochemical markers, including estrogen receptor (ER), progesterone receptor (PR), Ki67 index, and human epidermal growth factor receptor 2 (HER2) score, were examined before neoadjuvant treatment. Then, the diagnostic efficacy of SWE in different molecular subtypes was evaluated.
Results:
One-way analysis of variance revealed that age, tumor margin, the change in tumor size after chemotherapy, and the average (Emean), minimum (Emin), and maximum (Emax) values from shear wave elastography ultrasound before chemotherapy were related to the RECIST index. Multivariate regression revealed that age, tumor margin, the change in tumor size after chemotherapy, and Emax were independently correlated with the RECIST index. According to the ROC curve, the area under the curve (AUC) of Emax was 0.773. The AUC of Emean, Emin, and the ratio between tumor tissue and normal tissue (EI) were 0.630, 0.617, and 0.510, respectively. The Emax, Emin, Emean, and EI before and after NAC were significantly different (p ≤ 0.05). There was statistical significance in Luminal B type and HER2 enriched type in correlation results of the Emax values and RECIST indexes of different molecular subtypes. However, there was no significant difference in the Luminal A type and Triple negative types. There was no significant difference in the Emax values before NAC between the pathologic complete response (pCR) group and the non-pCR group (p > 0.05).
Conclusion:
Emax can be used to predict the response to NAC in women with invasive breast cancer, especially those with the Luminal B type and HER2 enriched type, but it cannot be used to predict pCR to NAC.
