超声波检查在局部晚期乳腺癌新辅助化疗后的反应评估中的作用:一家三级医疗中心的经验

Bidyut Biswas, Asif Ali, Arabinda Roy, Linkon Biswas
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引用次数: 0

摘要

目的:新辅助化疗(NACT)在局部晚期乳腺癌(LABC)的治疗中具有举足轻重的作用。方法:40 名 LABC 患者在开始 NACT 前接受了临床检查和双侧乳腺及腋窝超声波检查(USG)。接受三个周期的 NACT 治疗后,再次进行 USG 和临床检查,以评估对化疗的反应。有反应的患者接受了根治性手术,我们将组织病理学检查(HPE)结果与NACT后的USG检查结果进行了对比:结果:经过三个周期的 NACT 治疗后,临床检查显示 15 例(37.5%)患者完全应答,21 例(52.5%)患者部分应答。而 USG 检测出 8 例(20%)患者完全应答,28 例(70%)患者部分应答。HPE 显示 5 例标本的病理反应为完全反应,其余 31 例标本的病理反应为肿瘤残留。USG 没有漏检任何 pCR 病例,但高估了 9% 的 CR 病例(3 例患者)。另一方面,所有 USG 诊断为部分反应的病例都得到了 HPE 的认可:总之,可以说 USG 可以作为一种有效的放射学工具,用于反应评估和随后的治疗决策,尤其是在缺乏基础设施和负担不起的地方。
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ROLE OF ULTRASONOGRAPHY IN RESPONSE ASSESSMENT FOLLOWING NEOADJUVANT CHEMOTHERAPY IN LOCALLY ADVANCED BREAST CARCINOMA: EXPERIENCE FROM A TERTIARY CARE CENTER
Objective: Neo-adjuvant chemotherapy (NACT) has a pivotal role in the treatment of locally advanced breast carcinoma (LABC). In this study, we assess the efficiency of ultrasound in the response assessment of NACT in patients with LABC using RECIST criteria and its correlation to the final histopathological report. Methods: 40 patients with LABC underwent clinical examination and ultrasonography (USG) of the bilateral breast and axilla before starting NACT. After receiving three cycles of NACT, a repeat USG and clinical examination were done to assess the response to chemotherapy. Patients with responsive disease underwent radical surgery, and we correlate the findings of histopathological examination (HPE) with those of post-NACT USG findings. Results: After three cycles of NACT, clinical examination showed a complete response in 15 (37.5%) patients and a partial response in 21 (52.5%) patients. While USG detected a complete response in 8 (20%) patients and a partial response in 28 (70%) patients, seven patients, in whom clinical examination did not find any disease, were detected by USG. HPE showed a complete pathological response in 5 specimens, and in the rest of 31 cases, HPE revealed a residual tumor. USG did not miss any of the pCR cases but overestimated CR cases by 9% (3 patients). On the other hand, all partial response diagnoses by USG were acknowledged by HPE. Conclusion: To conclude, it can be said that USG can be used as an effective radiological tool for response assessment and subsequent treatment decisions, especially in places where there is a lack of infrastructure and affordability.
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