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Monitoring the response to neoadjuvant chemotherapy in patients with breast cancer using ultrasound scattering coefficient: A preliminary report

Katarzyna Dobruch-Sobczak
Katarzyna Dobruch-Sobczak
, 
Hanna Piotrzkowska-Wróblewska
Hanna Piotrzkowska-Wróblewska
, 
Ziemowit Klimoda
Ziemowit Klimoda
, 
Wojciech Secomski
Wojciech Secomski
, 
Piotr Karwat
Piotr Karwat
, 
Ewa Markiewicz-Grodzicka
Ewa Markiewicz-Grodzicka
, 
Agnieszka Kolasińska-Ćwikła
Agnieszka Kolasińska-Ćwikła
, 
Katarzyna Roszkowska-Purska
Katarzyna Roszkowska-Purska
 and 
Jerzy Litniewski
Jerzy Litniewski
   | Jun 28, 2019
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Article Category: original-paper
Published Online: Jun 28, 2019
Page range: 89 - 97
Received: Feb 13, 2019
Accepted: Apr 10, 2019
DOI: https://doi.org/10.15557/jou.2019.0013
Keywords
© 2019 Katarzyna Dobruch-Sobczak et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1.

A. B-mode images of Patient 1 present a hypoechoic, rounded, solid lesion, with lobular margins, without visible calcification, confirmed in histopathological verification as IC NST. B. Strain elastogram shows a Tsukuba 2 lesion. Stiff tissues are coded in red color, deformable in blue, and intermediate in green
A. B-mode images of Patient 1 present a hypoechoic, rounded, solid lesion, with lobular margins, without visible calcification, confirmed in histopathological verification as IC NST. B. Strain elastogram shows a Tsukuba 2 lesion. Stiff tissues are coded in red color, deformable in blue, and intermediate in green

Fig. 2.

A. B-mode image after NAC in Patient 1 presents an isoechoic lesion with irregular edges. B. Strain elastogram shows a Tsukuba 4 lesion
A. B-mode image after NAC in Patient 1 presents an isoechoic lesion with irregular edges. B. Strain elastogram shows a Tsukuba 4 lesion

Fig. 3.

A. B-mode image of Patient 8 before NAC presents an irregular, heterogeneous, hypoechoic solid lesion, with indistinct margins. B. Elastography predominates no strain in the tumor (Tsukuba 4)
A. B-mode image of Patient 8 before NAC presents an irregular, heterogeneous, hypoechoic solid lesion, with indistinct margins. B. Elastography predominates no strain in the tumor (Tsukuba 4)

Fig. 4.

A. B-mode image of Patient 8 after NAC presents a heterogeneous, hypoechoic and solid lesion. B. Elastography shows a Tsukuba 4 lesion
A. B-mode image of Patient 8 after NAC presents a heterogeneous, hypoechoic and solid lesion. B. Elastography shows a Tsukuba 4 lesion

Fig. 5.

A. Microscopic image of Patient 1 core-needle biopsy before treatment. The thick arrow indicates neoplastic cells and accompanying lymphocyte infiltration (thin arrow). B. Microscopic image of Patient 1 after treatment presents visible milk ducts (thin arrow) and stromal tissue (thick arrow), no visible neoplastic cells
A. Microscopic image of Patient 1 core-needle biopsy before treatment. The thick arrow indicates neoplastic cells and accompanying lymphocyte infiltration (thin arrow). B. Microscopic image of Patient 1 after treatment presents visible milk ducts (thin arrow) and stromal tissue (thick arrow), no visible neoplastic cells

Fig. 6.

A. Microscopic image of Patient 8 presets clusters of tumor cells from core-needle biopsy (thin arrow) and a band of fibrous tissue (thick arrow). B. Tumor cells after treatment in Patient 8: neoplastic cells (thin arrow) and stroma (thick arrow) with features of minor damage
A. Microscopic image of Patient 8 presets clusters of tumor cells from core-needle biopsy (thin arrow) and a band of fibrous tissue (thick arrow). B. Tumor cells after treatment in Patient 8: neoplastic cells (thin arrow) and stroma (thick arrow) with features of minor damage

Fig. 7.

Percentage change of the IBSC value after NAC
Percentage change of the IBSC value after NAC

Results of histopathological verification from core-needle biopsy and applied treatment

Patient n Pathology Grade ER % PGR % HER 2+ Ki-67 % IHCH type NAC type
1 NST 2 100 80 3 70 Luminalny B HER 2+ AT
2a, b NST 2 100 50 0 30 Luminalny B HER2− AT and Taxotere
3 NST 2 0 0 3 30 HER 2+ AT
4 NST 2 90 85 − 2 Luminalny A AC and paklitaksel
5 NST 1 100 80 − 2 Luminalny A Tamoksyfen
6 NST 2 80 40 1 2 Luminalny A AC and paklitaksel
7 NST 2 70 75 0 10 Luminalny A AC
8 NST 2 100 40 1 15 Luminalny A AC
9 NST + CDIS 2 90 40 1 30 Luminalny B HER 2− AC and paklitaksel
10a, b, c NST 3 100 60 − 60 Luminalny B HER 2− AC and paklitaksel

Breast tumor sizes before and after treatment as revealed in B-mode imaging, sonoelastography and final histopathological examinations

Patient n Tumor size before treatment (W × D × L) in mm Tumor size after treatment (W × D × L) in mm (Reduction in length compared to the initial result in %) RECIST 1.1 results Tsukuba scale before/after treatment Tumor size in final histopathological examination (mm)
1 8 × 10 × 9 4 × 3 × 3 (67%) PR 2/4 4 × 5 × 5
2a 19 × 27 × 17 12 × 7 × 8 (53%) PR 4/2 25 × 22 × 20
2b 35 × 41 × 36 9 × 9 × 6 (84%) PR 4/2 35 × 45 × 25
3 25 × 27 × 26 6 × 6 × 7 (73%) PR 4/3 40 × 30 × 20
4 20 × 23 × 25 10 × 8 × 12 (52%) PR 2/2 25 × 17 × 25
5 9 × 20 × 13 6 × 13 × 4 (69%) PR 5/5 22 × 17 × 18
6 22 × 13 × 21 18 × 20 × 11 (48%) PR 4/4 35 × 17 × 12
7 25 × 17 × 15 14 × 6 × 11 (27%) SD 4/2 13 × 12 × 11
8 30 × 21 × 41 20 × 16 × 34 (17%) SD 4/4 30 × 30 × 41
9 10 × 24 × 16 10 × 14 × 9 (44%) PR 2/2 0
10a 17 × 10 × 21 5 × 5 × 8 (62%) PR 3/4 9 × 7 × 11
10b 3 × 10 × 8 2 × 8 × 6 (25%) SD 3/3 0
10c 5 × 5 × 4 ** CR 2/2* 0

Microscopic assessment of tumor cell damage and tumor mass after chemotherapy

Patient n Reduction in cancer cells (%) Classification of histopathology
1 100% pCR
2a, b 60% G3
3 85% G3
4 30% G3
5 0% G1
6 0% G1
7 91% G4
8 0% G1
9 100% pCR
10a 95% G4
10b 100% pCR
10c 100% pCR
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