Clinical Value Of Neoadjuvant Chemo Therapeutic In Breast Cancer Microcalcificantion

ObjectiveTo explore the relationship between the changes of microcalcification in neoadjuvant chemotherapy of breast cancer and the pathological reaction?chemotherapy reaction MP grade of breast cancer,to explore whether the changes of microcalcification in mammography can provide the basis for evaluating the effect of chemotherapy in the course of clinical chemotherapy.MethodsA total of 500 patients underwent mammography from 2012-01-01 to 2017-05-31 in our hospital were examined by mammography.Breast lesions were found and biopsies were performed.Pathological biopsy confirmed invasive breast cancer,and the following conditions were met:calcification existed before neoadjuvant chemotherapy.Before neoadjuvant chemotherapy,mammography was taken before chemotherapy and before operation,and it can be compared and analyzed.In our hospital,88 breast cancer patients met the requirements according to pathological results and immunohistochemical results.The average age is 48.Mammography was performed then preserved the imaging data before/during neoadj-uvant chemotherapy and before the operation.According to the classification of BI-RADS,the X-ray diagnosis were described and determined.It is mainly the radiologic manifestations of suspected calcification.The forms of suspect calcification include amorp-hous calcification,rough and uneven calcification,small pleomorphic calcification,thin line or thin line branching calcification.The distribution of calcification includes in and surrounding the mass,outside the mass,in the mass,no mass with only calcification;The only calcification distribution includes diffuse distribution,regional distribution,cluster distribution,linear distribution,and segment distribution.ROI was choosed 2cm~2 at the same position between before/during neoadjuvant chemotherapy and before/aftet the oper-ation.The specimens were taken again on mammography camera and compared with those before and after chemotherapy.The changes of microcalcification in the breast were analyzed by two doctors who had experience in X-ray diagnosis over 10 years.When the opinion are abhorrent contrast with the original standard and then reach a consensus.Explore the relationship between the morphological,distribution and quantitative changes of calcification,pathological data and the chemotherapy reaction MP grade.Results1.After neoadjuvant chemotherapy,the rate of complete pathological remission was higher,but the probability of calcification reduction was only 26.1.The majority of calcific-ation remained stable.2.The difference was statistically significant(P<0.05)contrast the chemotherapy response MP(Miller&Payen Classification)classify with the change of calcification after neoadjuvant chemotherapy.3.The difference was statistically significant(P<0.05)contrast the distribution of calcification with the change of calcification after neoadjuvant chemotherapy.4.The difference was statistically significant(P<0.05)contrast the calcification morphology with the change of calcification after neoadjuvant chemoth-erapy.Conclusion1.Cases with decreased calcification had a higher rate of complete pathological response than those with constant calcification and increased calcification,neoadjuvant chemotherapy may evaluate the effect of chemotherapy by evaluated changes of microcalcification during mammography.2.Cases with reduced calcification were only more likely to be found in the mass,cases of increased calcification were distributed in and around masses or only outside the mass were higher ratio.3.The decrease proportion of small pleomorphic and thin line or thin line branching calcification was higher in the patients with decreased calcification after neoadjuvant chemotherapy.The probability of amorphous and rough uneven calcification in calcification invariant cases is higher.4.Increased calcification may represent the progression of the tumor,however,the presence of calcification does not necessarily represent the presence of lesions.In spite of this,after chemotherapy,all suspected calcification need be removed,in particular suspected calcification,which is distributed outside the mass.