Value of contrast-enhanced ultrasonography in evaluating the efficacy of neoadjuvant chemotherapy for triple negative breast cancer in the elderly / 中华老年医学杂志

ABSTRACT

Objective To evaluate the value of contrast-enhanced ultrasonography(CEUS)in neoadjuvant chemotherapy(NAC) for triple negative breast cancer(TNBC)in the elderly.Methods A total of 16 elderly patients with TNBC admitted to hospital from October 2017 to June 2018 were selected,and they underwent ultrasound examination before treatment.Changes in lesion size and time intensity curve (TIC)parameters were compared against postoperative microscopic diagnoses,which were used as the gold standard,to evaluate the effect of NAC in elderly TNBC patients.Results Compared with pre-treatment imaging data,the sum of the diameters of target lesions was reduced by 38.0％ after NAC treatment[(7.29±1.62)cm vs.(4.52± 1.21)cm,t =2.313,P＜0.05],and TIC parameters showed that the peak intensity(PI)and the time to peak(TTP)and the slope of the ascending part of the curve,or Grad,were statistically different between pre and post-NAC treatment measurements[(-65.14± 3.75)dB vs.(57.67± 1.93)dB,(11.57±7.34)s vs.(5.35±0.83)s,(1.21±0.27) vs.(2.29± 0.45),t =3.512,2.271 and 2.727,P =0.003,0.049 and 0.026,respectively].When compared with microscopic examination results,CEUS TIC analysis for evaluating the efficacy of NAC showed an accuracy of 87.5％ (14/16),a sensitivity of 92.9％ (13/14),a specificity of 50.0％ (1/2),a positive predictive value of 81.3％ (13/16) and an inter-method kappa value of 0.429(x2=0.500,P=0.230).Using CEUS to evaluate the efficacy of NAC achieved an accuracy rate of 81.3％(13/16).Conclusions CEUS can effectively evaluate the efficacy of NAC in elderly patients with TNBC,and guide the clinician to develop an accurate,individualized treatment program benefiting the patients.