超声和钼靶在预测乳腺癌新辅助化疗后病理反应中的准确性。
Accuracy of ultrasonography and mammography in predicting pathologic response after neoadjuvant chemotherapy for breast cancer.
机构信息
Department of Surgery, Division of Health Behavior Research, Washington University School of Medicine, St Louis, MO, USA.
出版信息
Am J Surg. 2010 Apr;199(4):477-84. doi: 10.1016/j.amjsurg.2009.03.012.
BACKGROUND
Neoadjuvant chemotherapy reduces tumor size before surgery in women with breast cancer. The aim of this study was to assess the ability of mammography and ultrasound to predict residual tumor size following neoadjuvant chemotherapy.
METHODS
In a retrospective review of consecutive breast cancer patients treated with neoadjuvant chemotherapy, residual tumor size estimated by diagnostic imaging was compared with residual tumor size determined by surgical pathology.
RESULTS
One hundred ninety-two patients with 196 primary breast cancers were studied. Of 104 tumors evaluated by both imaging modalities, ultrasound was able to size 91.3%, and mammography was able to size only 51.9% (chi(2)P < .001). Ultrasound also was more accurate than mammography in estimating residual tumor size (62 of 104 [59.6%] vs 33 of 104 [31.7%], P < .001). There was little difference in the ability of mammography and ultrasound to predict pathologic complete response (receiver operating characteristic, 0.741 vs 0.784).
CONCLUSIONS
Breast ultrasound was more accurate than mammography in predicting residual tumor size following neoadjuvant chemotherapy. The likelihood of a complete pathologic response was 80% when both imaging modalities demonstrated no residual disease.
背景
新辅助化疗可在乳腺癌女性患者手术前缩小肿瘤体积。本研究旨在评估乳腺钼靶和超声预测新辅助化疗后肿瘤残留大小的能力。
方法
对接受新辅助化疗的连续乳腺癌患者进行回顾性研究，对比诊断影像学评估的肿瘤残留大小与手术病理确定的肿瘤残留大小。
结果
共纳入 192 例 196 例原发性乳腺癌患者。104 例接受了两种影像学方法评估的肿瘤中，超声能准确评估 91.3%，而乳腺钼靶仅能评估 51.9%（χ²检验，P＜0.001）。超声在评估肿瘤残留大小方面也优于乳腺钼靶（104 例中有 62 例[59.6%]，而 104 例中有 33 例[31.7%]，P＜0.001）。乳腺钼靶和超声预测病理完全缓解的能力差异较小（受试者工作特征曲线下面积，0.741 比 0.784）。
结论
在预测新辅助化疗后肿瘤残留大小方面，乳腺超声优于乳腺钼靶。如果两种影像学方法均未显示残留疾病，则发生完全病理缓解的可能性为 80%。
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