Dighe Sajika, Shinde Raju, Shinde Sangita, Verma Prince
Department of Surgery, DMIMSU, Wardha, Maharashtra, India.
Department of Pharmacology, DMIMSU, Wardha, Maharashtra, India.
J Family Med Prim Care. 2022 Aug;11(8):4717-4722. doi: 10.4103/jfmpc.jfmpc_2186_21. Epub 2022 Aug 30.
To assess the response of neoadjuvant chemotherapy in carcinoma breast patients by high-frequency ultrasound.
The current single blind, observational study was conducted at rural tertiary healthcare center of Acharya Vinoba Bhave Rural Hospital from October 2018 to Sept 2020. We incorporated breast cancer patients with TNM stages IIIA and IIIB who received neoadjuvant chemotherapy with Cyclophosphamide/Adriamycin/5 FU and Paclitaxel respectively followed by standard surgical procedure modified radical mastectomy. Successive ultrasound examination of the breast malignancy and the axilla was done after 21 days of either of any neoadjuvant chemotherapy for 3 cycles. Assessment of response to neoadjuvant chemotherapy was applied in terms of reduction in the breast tumour volume on ultrasound and percentage of tumour response calculated by Response Evaluation Criteria for Solid Tumours (RECIST). Data were analysed using SPSS version 24.0.
Higher frequency of patients was invasive ductal breast cancer. In our study, Paclitaxel group showed better response in terms of CR and PR than CAF group. Our study noticed a consistent decrement in tumour volume after every cycle of either CAF or Paclitaxel NACT. Axillary ultrasound was able to predict the response of axillary lymph nodes in terms of increase or decrease in number and morphological changes after 3 cycles of NACT with similarity on final histopathology.
It can be concluded from the results of the present study that high-frequency ultrasound is appropriate tool for assessment of response of primary breast malignancy and lymphnode metastasis in the axilla after neoadjuvant chemotherapy.
通过高频超声评估乳腺癌患者新辅助化疗的反应。
本单盲观察性研究于2018年10月至2020年9月在阿查里亚·维诺巴·巴韦农村医院的农村三级医疗中心进行。我们纳入了TNM分期为IIIA和IIIB期的乳腺癌患者，他们分别接受了环磷酰胺/阿霉素/5-氟尿嘧啶和紫杉醇的新辅助化疗，随后进行了标准手术改良根治性乳房切除术。在任何一种新辅助化疗21天后，对乳腺恶性肿瘤和腋窝进行连续超声检查，共进行3个周期。根据超声检查中乳腺肿瘤体积的减小以及实体瘤疗效评价标准（RECIST）计算的肿瘤反应百分比来评估新辅助化疗的反应。使用SPSS 24.0版对数据进行分析。
患者中浸润性导管癌的发生率较高。在我们的研究中，紫杉醇组在完全缓解（CR）和部分缓解（PR）方面的反应优于环磷酰胺/阿霉素/5-氟尿嘧啶（CAF）组。我们的研究发现，CAF或紫杉醇新辅助化疗的每个周期后，肿瘤体积均持续减小。腋窝超声能够在新辅助化疗3个周期后，根据腋窝淋巴结数量的增加或减少以及形态变化预测其反应，最终病理检查结果与之相似。
从本研究结果可以得出结论，高频超声是评估新辅助化疗后原发性乳腺恶性肿瘤和腋窝淋巴结转移反应的合适工具。
