Research of Ultrasonic Shear Wave Elastography in Evaluating the Efficiency of Neoadjuvant Chemotherapy for Breast...

This study aimed to identify reliable quantitative parameters of ultrasonic shear wave elastography (SWE) that demonstrate advantages in assessing the efficacy of neoadjuvant chemotherapy (NAC) for breast cancer by comparison to conventional ultrasound (US). This research also analyzed the associations between SWE parameters and tumor collagen fibers from post-NAC breast cancer lesions to explore the histological micro-mechanisms of stiffness change for breast cancer after NAC.

Forty-Seven breast cancer lesions examined with US and SWE were eligible for enrollment from January 2021 to July 2023. The ultrasonic maximum diameter (D_max), mean elastic value (E_mean), maximum elastic value (E_max), and minimum elastic value (E_min) before and after NAC were determined. Receiver operating characteristic (ROC) curves were drawn to compare the diagnostic efficacy regarding the change rates of the above parameters. Additionally, correlation analyses were performed to examine the relationship between effective SWE quantitative parameters and collagen fibers after NAC.

Among the 47 breast cancer lesions, 24 lesions showed significant pathological responses, while the other 23 lesions exhibited that the pathological responses were nonsignificant. The area under the curve (AUC) of ΔE_min was the lowest (ΔE_min:0.466, ΔD_max: 0.679, ΔE_max: 0.803, and ΔE_mean: 0.813). The collagen fiber category showed a significant positive correlation with E_mean (r = 0.711) and E_max (r = 0.669) after NAC. However, the collagen fiber content demonstrated no significant correlation with E_mean or E_max (p > 0.05).

D_max, E_mean, and E_max are valuable parameters for evaluating NAC efficacy, while Emin is not reliable. E_mean and E_max demonstrate similar efficacy, both superior to D_max. The stiffness of post-NAC breast cancer lesions is predominantly related to the category of collagen fibers rather than their content.