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

BIDYUT BISWAS; MD ASIF ALI; ARABINDA ROY; LINKON BISWAS

doi:10.22159/ajpcr.2024.v17i6.50477

Authors

BIDYUT BISWAS Department of Surgery, Raiganj Government Medical College and Hospital, Raiganj, West Bengal, India
MD ASIF ALI Department of Radiology, Raiganj Government Medical College and Hospital, Raiganj, West Bengal, India.
ARABINDA ROY Department of Radiotherapy, Raiganj Government Medical College and Hospital, Raiganj, West Bengal, India.
LINKON BISWAS Department of Radiotherapy, Nilratan Sircar Medical College and Hospital, Kolkata, West Bengal, India https://orcid.org/0000-0003-0589-769X

DOI:

https://doi.org/10.22159/ajpcr.2024.v17i6.50477

Keywords:

Locally advanced breast cancer, USG, Neo-adjuvant chemotherapy, Response Assessment.

Abstract

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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