Locally advanced breast carcinoma: computer assisted semiquantitative analysis of color Doppler ultrasonography in the evaluation of tumor response to neoadjuvant chemotherapy (work in progress).

Abstract

We aimed to evaluate objectively the value of color Doppler flow imaging in the assessment of response of locally advanced breast cancer to primary medical treatment by using a computer assisted semiquantitative method. Prior to and after neoadjuvant treatment, 17 patients with locally advanced breast carcinoma were prospectively evaluated by physical examination and computer assisted semiquantitative color Doppler ultrasonography. The results of clinical and color Doppler examination were finally correlated to the histopathologic evaluation of tumor response. The degree of concordance between posttherapeutic histopathologic results, clinical examination, and color Doppler assessment was evaluated by kappa statistics. Concordance was 0.474 (0.135‐0.813) between histopathologic results and clinical posttherapeutic assessment and 0.870 (0.627‐1.113) between histopathologic results and semiquantitative color Doppler examination. Objective semiquantitative assessment of tumor vascularity as displayed by color Doppler ultrasonography has potential as a functional tool for measuring tumor response to neoadjuvant chemotherapy.

Microwave imaging for neoadjuvant chemotherapy monitoring: initial clinical experience

“…Conventional breast imaging modalities, such as ultrasound and mammography, have been disappointing in detecting the extent of residual disease during treatment [9]. Studies have also been conducted using Doppler ultrasonography, diffuse optical spectroscopy and tomography and scintimammography [10-13]. Assessing tumor shrinkage by clinical breast examination is possible as well but is poorly correlated with treatment response [1].…”

Response to Neoadjuvant Treatment in Patients with Locally Advanced Breast Cancer

“…A detailed vascular map, which is both qualitative and quantitative, is an important indicator of the biological activity of the residual neoplasm and appears to be necessary for a more accurate assessment of the efficacy of the neoadjuvant treatment (Huber et al, 2000).…”

Blood Flow Indices by Doppler Ultrasonography Vary with Neoadjuvant Chemotherapy but Are Not Related to Plasma VEGF Levels in Locally Advanced Breast Cancer

“…Clinical and/or radiological and pathological response evaluations do not always correlate. Misinterpretation due to residual fibrosis or poorly defined tumor margins is possible [7]. …”

“…Color Doppler ultrasonography (DUSG) is a noninvasive and quite cheap technique to determine vascularity and may predict treatment response in various tumors, including breast carcinoma [3, 7, 8]. It could be of value to determine which patients with breast cancer are more dependent on vascular blood flow, in other words which patients will likely benefit from antiangiogenic therapy.…”