Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine and Science, 200 First Street SW, Rochester, MN, 55905, USA.
Department of Health Science, Mayo Clinic College of Medicine and Science, Rochester, MN, 55905, USA.
Breast Cancer Res. 2021 Apr 29;23(1):52. doi: 10.1186/s13058-021-01429-4.
Early prediction of tumor response to neoadjuvant chemotherapy (NACT) is crucial for optimal treatment and improved outcome in breast cancer patients. The purpose of this study is to investigate the role of shear wave elastography (SWE) for early assessment of response to NACT in patients with invasive breast cancer.
In a prospective study, 62 patients with biopsy-proven invasive breast cancer were enrolled. Three SWE studies were conducted on each patient: before, at mid-course, and after NACT but before surgery. A new parameter, mass characteristic frequency (f), along with SWE measurements and mass size was obtained from each SWE study visit. The clinical biomarkers were acquired from the pre-NACT core-needle biopsy. The efficacy of different models, generated with the leave-one-out cross-validation, in predicting response to NACT was shown by the area under the receiver operating characteristic curve and the corresponding sensitivity and specificity.
A significant difference was found for SWE parameters measured before, at mid-course, and after NACT between the responders and non-responders. The combination of E and mass size (s) gave an AUC of 0.75 (0.95 CI 0.62-0.88). For the ER+ tumors, the combination of E, s, and Ki-67 index gave an improved AUC of 0.84 (0.95 CI 0.65-0.96). For responders, f was significantly higher during the third visit.
Our study findings highlight the value of SWE estimation in the mid-course of NACT for the early prediction of treatment response. For ER+ tumors, the addition of Ki-67improves the predictive power of SWE. Moreover, f is presented as a new marker in predicting the endpoint of NACT in responders.
早期预测肿瘤对新辅助化疗（NACT）的反应对于乳腺癌患者的最佳治疗和改善预后至关重要。本研究旨在探讨剪切波弹性成像（SWE）在评估浸润性乳腺癌患者 NACT 早期反应中的作用。
在一项前瞻性研究中，纳入了 62 例经活检证实的浸润性乳腺癌患者。每位患者进行了 3 次 SWE 研究：NACT 前、中期和 NACT 后但手术前。从每次 SWE 研究访问中获得新参数质量特征频率（f）以及 SWE 测量值和肿块大小。临床生物标志物是从 NACT 前的核心针活检中获得的。通过受试者工作特征曲线下面积和相应的灵敏度和特异性，显示了使用留一交叉验证生成的不同模型预测 NACT 反应的效果。
在反应者和非反应者之间，在 NACT 前、中期和 NACT 后测量的 SWE 参数存在显著差异。E 和肿块大小（s）的组合 AUC 为 0.75（0.95CI 0.62-0.88）。对于 ER+肿瘤，E、s 和 Ki-67 指数的组合可提高 AUC 至 0.84（0.95CI 0.65-0.96）。对于反应者，f 在第三次访问时显著升高。
本研究结果强调了 SWE 估计在 NACT 中期在早期预测治疗反应中的价值。对于 ER+肿瘤，Ki-67 的加入提高了 SWE 的预测能力。此外，f 作为预测反应者 NACT 终点的新标志物被提出。
