The Clinical Value Of Ultrasonography And Pathology In Curative Effect Of Neoadjuvant Chemotherapy For Breast Cancer

Objective:The aim of our study was to explore the correlation between clinical palpation,changes in tumor size,blood flow,axillary lymph node size in Ultrasonography and changes of ER,PR,her-2 and ki67 in molecular biology and the efficacy of neoadjuvant chemotherapy in breast cancer,so as to evaluate and guide the efficacy of neoadjuvant chemotherapy.Methods:Eighty-seven women diagnosed with primary breast cancer who underwent NCT and surgery from June 2016 to December 2018 selected,in the department of breast surgery,qilu hospital,shandong university.All patients underwent ultrasonography and clinical palpation before each neoadjuvant chemotherapy and surgery,ultrasonography and clinical palpation were conducted by experienced doctors.The size of the tumor in clinical palpation and the size of the tumor,blood flow changes,the size of the axillary lymph node in ultrasonography shouid be recorded.Record the Immunohistochemical results of patients underwent Needle Biopsy and surgery,including ER?PR?HER-2/neu?ki-67.The above data were retrospectively analyzed.The clinical efficacy evaluation of neoadjuvant chemotherapy was based on RECIST guideline efficacy evaluation criteria,and the pathological efficacy evaluation was based on Miller&Payne grading method.For all the data,SPSS 19.0 was used for statistical analysis.Results:Clinical palpation:the effective rate was 77.01%%,the maximum diameter of the tumor decreased significantly after NCT(p<0.01),Compared with pathological evaluation,the sensitivity was 0.7377,the specificity was 0.1538,and the clinical efficacy was inconsistent with the pathological evaluation,and there was no correlation(p =0.244).Changes in tumor size measured by ultrasound:the effective rate was 71.26%,and the maximum diameter of the tumor decreased significantly after NCT(p<0.01).Compared with pathological evaluation,the sensitivity was 0.8361,and the specificity was 0.615.Changes in tumor size measured by ultrasound were consistent with pathological evaluation,and there was a correlation(p=0.008).Blood flow changes in Ultrasonography:the effective rate was 71.26%,and the blood flow grade decreased significantly after NCT(P<0.01).Compared with the pathological evaluation,the sensitivity was 0.8033,and the specificity was 0.5.The blood flow evaluation was consistent with the pathological evaluation,and there was a correlation(P=0.004).Axillary lymph nodes in Ultrasonography:the effective rate was 80%;the maximum diameter of axillary lymph nodes decreased significantly after NCT(p<0.01);compared with pathological evaluation,the sensitivity was 0.8235;the specificity was 0.3684;the change of ultrasonic axillary lymph nodes size was consistent with pathological evaluation,and there was a correlation(p=0.004).There was no statistically significant in the change of ER?PR?HER-2/neu before and after NCT(p>0.05).Ki-67 decreased significantly after NCT(P<0.05).There was no significant correlation between ER?PR?HER-2/neu changes and pathological MP grading,and the results were no statistically significant(p>0.05).The changes of ki-67 before and after NCT were correlated with pathological MP grading,and the results has statistically significant(P=0.008).Conclusions:1.The change of mass size of the breast cancer measureed by ultrasonography can be used to evaluate the efficacy of neoadjuvant chemotherapy,and is consistent with pathological evaluation.2.Blood flow changes in breast cancer measureed by ultrasonography can be used to evaluate the efficacy of neoadjuvant chemotherapy,and is consistent with pathological evaluation.3.The changes of axillary lymph node size measured by ultrasound can be used to evaluate the efficacy of neoadjuvant chemotherapy and are consistent with pathological evaluation.4.The changes of Ki67 in molecular biological indicators can be used to evaluate the efficacy of neoadjuvant chemotherapy,which is consistent with the pathological evaluation and can be used as a predictive indicator of the efficacy of neoadjuvant chemotherapy.