Comparative Analysis Between Ultrasound And Magnetic Resonance Imagining On Assessment Of Neoadjuvant Chemotherapy For Breast Cancer

ObjectiveNeoadjuvant chemotherapy(NAC)has already become a significant part of comprehensive treatment to early stage and locally advanced breast cancer.Evidence-based medicine shows that patients who achieve pathological complete outcome(pCR) after treatment of NAC obtain a far better outcome in survival.Accurate evaluation to effect of NAC is an important precondition to adjust chemotherapy and decide operable opportunity.Pathology assessment is the golden standard for NAC,but it's restricted by invasive operation and hysteretic assessment.In this situation clinical examination and imaging examination become vital approach to evaluate NAC.This research retrospectively analyses patients after NAC to discuss the value of clinical examination Color Doppler ultrasound and magnetic resonance imaging(MRI) to assess NAC in hope to give clinic guideline for NAC and provide demonstration for individualized treatment of breast cancer.MethodsOur study selected 98 patients with breast cancer treated by neoadjuvant chemotherapy from March 2012 to January 2013.Patients were examined with color doppler ultrasound and MRI before and after 4 cycles of neoadjuvant chemotherapy respectively.The longest diameter of tumors were measured by physical examination?ultrasound and MRI,Tumor shapes?echoes and blood flow degree measured by ultrasound, together with time-signal intensity curves measured by MRI were documented.Miller-Payne degree system was employed as gold standard.patients with MP degree1?2?3were classified in major histological response(MHR) group,the others with degree3?4were classified in Non-major histological (NMHR)group Response evaluation criteria in solid tumors(RECIST) was used as morphology standard.The statistical Package for Social Science(SPSS)19.0 was used,and p-value less than 0.05 was assumed as significant.Results42 of 98 patients were diagnosed as MHR under Miller-Payne degree system,56 patients were diagnosed as NMHR.MRI (r=0.852, P=0.005) was better than ultrasound (r=0.636,p=0.005) and physical examination (r=0.374,p=0.049) in relation between measured longest diameters and histological diameters of tumors.The veracity of physical examination was 57%,correlation coefficient with histological measurement was 0.171, P=0.036;ultrasound showed 88% in veracity and 0.679 in correlation coefficient,P=0.000;MRI showed 91% in veracity and 0.748 in correlation coefficient,P=0.000;the outcome of MRI became 84% and 0.618 plus TIC analysis,P=0.000.In MHR group,Ultrasound changed significantly in terms of shape(irrgeluar 13 up to 22,P< 0.05)?boundary(clear 3 up to 15,P< 0.05)?rear echoes(normal 9 up to 21,P< 0.05)?blood flow(0-I 2 up to 14,P< 0.05)after NAC,the change in enhanced circle(with circle 5 down to 2,p=0.218)?inner echos(echos increased 6 up to 8,P=0.522) was non-significant.In NMHR group,the change of shape(irrgeluar 26 up to 41,P< 0.05)?enhanced circle(with circle 21 down to 6,P< 0.05)?inner echos(echos increased 12 up to 23,P< 0.05)and blood flow(0-I 6 up to 15 P< 0.05) was significant after NAC,the other index was non-significant.Before NAC,MRI showed more type-? and type-? blood flow signal in TIC(97/98) while more type-? blood flow signal emerging (1 up to 10,P< 0.05),especially in MHR group(1 up to 11,P< 0.05)after NAC,which were both significant.Conclusion1.Both ultrasound and MRI provides an effective method in the evaluation of the effect of NAC in patients with primary breast cancer.2.MRI is better than ultrasound in evaluating the effect of NAC with a higher correlation coefficient with histological measurement.3.After NAC,the ultrasound change in form?boundary?echoes and blood flow under CDFI and the change of TIC in MRI provide reference for the assessment in treating tumors of breast cancer.