Early Evaluation of Relative Changes in Tumor Stiffness by Shear Wave Elastography Predicts the Response to Neoadjuvant Chemotherapy in Patients With Breast Cancer.
OBJECTIVE
Neoadjuvant chemotherapy plays an important role in comprehensive therapy for breast cancer, but response prediction is imperfect. Shear wave elastography (SWE) is a novel technique that can quantitatively evaluate tissue stiffness. In this study, we sought to investigate the application value of SWE for early prediction of the response to neoadjuvant chemotherapy in patients with breast cancer.


METHODS
We prospectively evaluated tumor stiffness in 62 patients with breast cancer using SWE, which was performed at baseline and after the second cycle of neoadjuvant chemotherapy. After chemotherapy, all of the patients underwent surgery. We investigated the correlations between the relative changes in tumor stiffness (Δ stiffness) after 2 cycles of chemotherapy and the pathologic response to the therapy.


RESULTS
Compared with baseline values, tumor stiffness after 2 cycles of neoadjuvant chemotherapy was significantly decreased in responders (P < .001) but not in nonresponders (P = .172). The Δstiffness was significantly higher in responders (-42.194%) than in nonresponders (-23.593%; P = .001). As determined at either the baseline or after the second cycle of chemotherapy, tumor stiffness was significantly lower in responders than in nonresponders (P = .033 and .009, respectively). The Δ stiffness threshold for distinguishing between responders and nonresponders was -36.1% (72.92% sensitivity and 85.71% specificity). Furthermore, correlating Δ stiffness with clinical and pathologic characteristics, we found that estrogen and progesterone receptor expression showed statistically significant correlations with Δ stiffness (estrogen receptor, P = .008; progesterone receptor, P = .023).


CONCLUSIONS
Early evaluation of relative changes in tumor stiffness using SWE could effectively predict the response to neoadjuvant chemotherapy in patients with breast cancer and might indicate better therapeutic strategies on a timelier basis.
Department of Ultrasound, Second Affiliated Hospital of Harbin Medical University, Harbin, China. Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin, China.
Hui
H
Jing
Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin, China.
Wen
W
Cheng
Department of Ultrasound, Second Affiliated Hospital of Harbin Medical University, Harbin, China.
Zi-Yao
ZY
Li
Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin, China.
Liu
L
Ying
Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin, China.
Qiu-Cheng
QC
Wang
Department of Ultrasound, Second Affiliated Hospital of Harbin Medical University, Harbin, China.
Tong
T
Wu
Department of Ultrasound, Second Affiliated Hospital of Harbin Medical University, Harbin, China jwtian2004@163.com.
Jia-Wei
JW
Tian
D000328:Adult; D000368:Aged; D001940:Breast / Q000000981:diagnostic imaging / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016896:Treatment Outcome
breast cancer; breast ultrasound; neoadjuvant chemotherapy; pathologic response; shear wave elastography; tumor stiffness