The role of shear wave elastography in early prediction of response to neaodjuvant chemotherapy in cases of breast cancer

BackgroundBreast cancer is the most common malignant tumor and the commonest cause of death in female between 35 and 55 years of age. Neoadjuvant chemotherapy (NACT) is used in large scale nowadays in management of breast cancer. Recent studies propose that shear wave elastography (SWE) can early predict tumor therapy response during NACT for invasive breast cancer.Aim of workTo study the ability of SWE to predict pathological complete response (pCR) during NACT as early as first cycle.Subjects and methodsThe study analyzed data of 48 patients breast cancer who were scheduled for receiving NACT before surgery. During treatment, SWE examination was done at first four cycles.ResultsForty-eight breast cancer cases were included in the study with one hundred and ninety two examinations done. The cutoff point of stiffness ratio percent change post-first cycle in differentiating pCR and npCR groups was - 20% (AUC 0.755, sensitivity 81.8%, specificity 61.5%). The cutoff point of stiffness ratio percent change post-second cycle in differentiating pCR and npCR groups was - 49% (AUC 0.741, sensitivity 72.7%, specificity 76.9%). The stiffness ratio could predict pCR in early cycles of NACT.ConclusionsUS using shear wave elastography is an available, cheap, non-contrast, non-ionizing radiation method that predicts pCR in cases of breast cancer at neoadjuvant setting as early as first cycle.