Strain ultrasonic elastography imaging features of locally advanced breast cancer: association with response to neoadjuvant chemotherapy and recurrence-free survival
Abstract Background Due to the highly heterogeneity of the breast cancer, it would be desirable to obtain a non-invasive method to early predict the treatment response and survival outcome of the locally advanced breast cancer (LABC) patients undergoing neoadjuvant chemotherapy (NAC). This study aim...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | BMC Medical Imaging |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12880-023-01168-2 |
| _version_ | 1797376692206960640 |
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| author | Caifeng Wan Liheng Zhou Ye Jin Fenghua Li Lin Wang Wenjin Yin Yaohui Wang Hongli Li Lixin Jiang Jinsong Lu |
| author_facet | Caifeng Wan Liheng Zhou Ye Jin Fenghua Li Lin Wang Wenjin Yin Yaohui Wang Hongli Li Lixin Jiang Jinsong Lu |
| author_sort | Caifeng Wan |
| collection | DOAJ |
| description | Abstract Background Due to the highly heterogeneity of the breast cancer, it would be desirable to obtain a non-invasive method to early predict the treatment response and survival outcome of the locally advanced breast cancer (LABC) patients undergoing neoadjuvant chemotherapy (NAC). This study aimed at investigating whether strain elastography (SE) can early predict the pathologic complete response (pCR) and recurrence-free survival (RFS) in LABC patients receiving NAC. Methods In this single-center retrospective study, 122 consecutive women with LABC who underwent SE examination pre-NAC and after one and two cycles of NAC enrolled in the SHPD001(NCT02199418) and SHPD002 (NCT02221999) trials between January 2014 and August 2017 were included. The SE parameters (Elasticity score, ES; Strain ratio, SR; Hardness percentage, HP, and Area ratio, AR) before and during NAC were assessed. The relative changes in SE parameters after one and two cycles of NAC were describe as ΔA1 and ΔA2, respectively. Logistic regression analysis and Cox proportional hazards model were used to identify independent variables associated with pCR and RFS. Results Forty-nine (40.2%) of the 122 patients experienced pCR. After 2 cycles of NAC, SR2 (odds ratio [OR], 1.502; P = 0.003) and ΔSR2 (OR, 0.013; P = 0.015) were independently associated with pCR, and the area under the receiver operating characteristic curve for the combination of them to predict pCR was 0.855 (95%CI: 0.779, 0.912). Eighteen (14.8%) recurrences developed at a median follow-up of 60.7 months. A higher clinical T stage (hazard ratio [HR] = 4.165; P = 0.005.), a higher SR (HR = 1.114; P = 0.002.) and AR (HR = 1.064; P < 0.001.) values at pre-NAC SE imaging were independently associated with poorer RFS. Conclusion SE imaging features have the potential to early predict pCR and RFS in LABC patients undergoing NAC, and then may offer valuable predictive information to guide personalized treatment. |
| first_indexed | 2024-03-08T19:43:20Z |
| format | Article |
| id | doaj.art-4b3374759c6749d3b2f1fb606d86b880 |
| institution | Directory Open Access Journal |
| issn | 1471-2342 |
| language | English |
| last_indexed | 2024-03-08T19:43:20Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
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| series | BMC Medical Imaging |
| spelling | doaj.art-4b3374759c6749d3b2f1fb606d86b8802023-12-24T12:32:21ZengBMCBMC Medical Imaging1471-23422023-12-0123111210.1186/s12880-023-01168-2Strain ultrasonic elastography imaging features of locally advanced breast cancer: association with response to neoadjuvant chemotherapy and recurrence-free survivalCaifeng Wan0Liheng Zhou1Ye Jin2Fenghua Li3Lin Wang4Wenjin Yin5Yaohui Wang6Hongli Li7Lixin Jiang8Jinsong Lu9Department of Breast Surgery, Renji Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Breast Surgery, Renji Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Ultrasound, Renji Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Ultrasound, Renji Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Ultrasound, Renji Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Breast Surgery, Renji Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Breast Surgery, Renji Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Ultrasound, Renji Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Ultrasound, Renji Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Breast Surgery, Renji Hospital, Shanghai Jiao Tong University School of MedicineAbstract Background Due to the highly heterogeneity of the breast cancer, it would be desirable to obtain a non-invasive method to early predict the treatment response and survival outcome of the locally advanced breast cancer (LABC) patients undergoing neoadjuvant chemotherapy (NAC). This study aimed at investigating whether strain elastography (SE) can early predict the pathologic complete response (pCR) and recurrence-free survival (RFS) in LABC patients receiving NAC. Methods In this single-center retrospective study, 122 consecutive women with LABC who underwent SE examination pre-NAC and after one and two cycles of NAC enrolled in the SHPD001(NCT02199418) and SHPD002 (NCT02221999) trials between January 2014 and August 2017 were included. The SE parameters (Elasticity score, ES; Strain ratio, SR; Hardness percentage, HP, and Area ratio, AR) before and during NAC were assessed. The relative changes in SE parameters after one and two cycles of NAC were describe as ΔA1 and ΔA2, respectively. Logistic regression analysis and Cox proportional hazards model were used to identify independent variables associated with pCR and RFS. Results Forty-nine (40.2%) of the 122 patients experienced pCR. After 2 cycles of NAC, SR2 (odds ratio [OR], 1.502; P = 0.003) and ΔSR2 (OR, 0.013; P = 0.015) were independently associated with pCR, and the area under the receiver operating characteristic curve for the combination of them to predict pCR was 0.855 (95%CI: 0.779, 0.912). Eighteen (14.8%) recurrences developed at a median follow-up of 60.7 months. A higher clinical T stage (hazard ratio [HR] = 4.165; P = 0.005.), a higher SR (HR = 1.114; P = 0.002.) and AR (HR = 1.064; P < 0.001.) values at pre-NAC SE imaging were independently associated with poorer RFS. Conclusion SE imaging features have the potential to early predict pCR and RFS in LABC patients undergoing NAC, and then may offer valuable predictive information to guide personalized treatment.https://doi.org/10.1186/s12880-023-01168-2Neoadjuvant chemotherapyLocally advanced breast cancerStrain elastographyStrain ratioRecurrence-free survival |
| spellingShingle | Caifeng Wan Liheng Zhou Ye Jin Fenghua Li Lin Wang Wenjin Yin Yaohui Wang Hongli Li Lixin Jiang Jinsong Lu Strain ultrasonic elastography imaging features of locally advanced breast cancer: association with response to neoadjuvant chemotherapy and recurrence-free survival BMC Medical Imaging Neoadjuvant chemotherapy Locally advanced breast cancer Strain elastography Strain ratio Recurrence-free survival |
| title | Strain ultrasonic elastography imaging features of locally advanced breast cancer: association with response to neoadjuvant chemotherapy and recurrence-free survival |
| title_full | Strain ultrasonic elastography imaging features of locally advanced breast cancer: association with response to neoadjuvant chemotherapy and recurrence-free survival |
| title_fullStr | Strain ultrasonic elastography imaging features of locally advanced breast cancer: association with response to neoadjuvant chemotherapy and recurrence-free survival |
| title_full_unstemmed | Strain ultrasonic elastography imaging features of locally advanced breast cancer: association with response to neoadjuvant chemotherapy and recurrence-free survival |
| title_short | Strain ultrasonic elastography imaging features of locally advanced breast cancer: association with response to neoadjuvant chemotherapy and recurrence-free survival |
| title_sort | strain ultrasonic elastography imaging features of locally advanced breast cancer association with response to neoadjuvant chemotherapy and recurrence free survival |
| topic | Neoadjuvant chemotherapy Locally advanced breast cancer Strain elastography Strain ratio Recurrence-free survival |
| url | https://doi.org/10.1186/s12880-023-01168-2 |
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