ROLE OF USG IN RESPONSE ASSESSMENT FOLLOWING NEOADJUVANT CHEMOTHERAPY IN LOCALLY ADVANCED BREAST CARCINOMA: EXPERIENCE FROM A TERTIARY CARE CENTRE

Abstract

Objective: Neo-adjuvant chemotherapy (NACT) has a pivotal role in treatment of locally advanced breast carcinoma (LABC). In this study we assess the efficiency of ultrasound in response assessment of NACT in patients with LABC using RECIST criteria and its correlation to final histopathological report.

Methods: 40 patients with LABC underwent clinical examination and USG of bi-lateral breast and axilla before starting NACT. After receiving three cycles of NACT, repeat USG and Clinical examination was done to assess the response to chemotherapy. Patients with responsive disease underwent radical surgery and we correlate the findings of histopathological examination with that of post-NACT USG findings.

Results:

After three cycles of NACT , Clinical examination showed complete response in 15 (37.5%) patients and partial response in 21 (52.5%) patients. While USG detected Complete response in 8 (20%) patients and Partial response in 28 (70%) patients. Seven patients in whom clinical examination did not find any disease, were detected by USG.HPE showed complete pathological response in 5 specimens and in rest 31 cases HPE revealed residual tumour. USG did not miss any of the pCR cases, but overestimates CR cases by 9% (3 patients). On the other hand all partial response diagnosis by USG was acknowledged by HPE.

Conclusion:

To conclude it can be said that USG can be used as an effective radiological tool for response assessment and sub-sequent treatment decisions, especially in places where there is lack of infrastructure and affordability.

  Keywords: Locally advanced breast cancer, USG, Neo-adjuvant chemotherapy, Response

 Assessment.