title: [Comparison of response evaluation methods of neoadjuvant chemotherapy in breast cancer patients].
abstract: OBJECTIVE
  To compare the efficiency of response evaluation by clinical examination, ultrasonograghy and mammography in neoadjuvant chemotherapy (NAC) for breast cancer.
  
  
  METHODS
  A retrospective cohort study was conducted to analyze the data of 141 patients treated with neoadjuvant chemotherapy. Response evaluation was performed by clinical palpation, ultrasound and mammography.
  
  
  RESULTS
  Only 12 (8.5%) among the 141 patients presented with a stage I tumor. The tumor size determined by palpation was often larger than that by ultrasound before therapy (P < 0.01). Among patients with suspicions axillary nodes checked by ultrasound, 88.3% (53/60) of them had positive nodes by pathology before NAC, and 34.5% (10/29) of patients with negative nodes determined by ultrasound had positive nodes by pathology. In all the 141 patients, 21(14.9%) showed pathological complete remission in both the primary tumor and lymph node. For response evaluation, the false complete remission rate judged by clinical examination was 46.8% (22/47), and the false tumor residual rate by ultrasound was 84.0% (21/25). In 53.5% (23/43) of patients the response could not be assessed by mammography due to that the tumors were undistinguishable in size. The range of microcalcification was not reduced in 5 patients with a partial response of the tumor. 25 patients experienced needle puncture during therapy. Among them, in the 9 pathologically negative patients, only 3 achieved pCR, and the other 16 positive patients didn't achieve pCR.
  
  
  CONCLUSIONS
  Using the puncture or sentinel lymph node biopsy, clinicians should pay enough emphasis on the pathological determination of the node status before chemotherapy. Clinicians will make a quite of false judgment of the tumor by clinical examination, ultrasound or mammography. They may use needle puncture during therapy to evaluate the response of neoadjuvant chemotherapy, and the result should be analyzed synthetically.
authors.affiliation: Department of Breast Cancer, Affiliated Hospital of the Academy of Military Medical Sciences, Beijing 100071, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Sun
authors.forename: San-tai
authors.initials: ST
authors.lastname: Song
authors.forename: Shi-kai
authors.initials: SK
authors.lastname: Wu
authors.forename: Ze-fei
authors.initials: ZF
authors.lastname: Jiang
authors.forename: Tao
authors.initials: T
authors.lastname: Wang
authors.forename: Shao-hua
authors.initials: SH
authors.lastname: Zhang
authors.forename: Yi-bing
authors.initials: YB
authors.lastname: Zhao
authors.forename: Cheng-ze
authors.initials: CZ
authors.lastname: Yu
authors.forename: Xiao-bing
authors.initials: XB
authors.lastname: Li
authors.forename: Tao
authors.initials: T
authors.lastname: Yang
authors.forename: Gong-jie
authors.initials: GJ
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008327:Mammography; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D012074:Remission Induction / Q000379:methods; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D014463:Ultrasonography