Shear-wave elastography (SWE) is an effective tool in discriminating malignant lesions of breast and axillary lymph node metastasis in patients with breast cancer. However, the association between the baseline elasticity value of breast cancer and the treatment response of neoadjuvant chemotherapy is yet to be elucidated. Baseline SWE measured mean stiffness (E-mean) and maximum stiffness (E-max) in 830 patients who underwent neoadjuvant chemotherapy and surgery from January 2012 to December 2022. Association of elasticity values with breast pCR (defined as ypTis/T0), pCR (defined as ypTis/T0, N0), and tumor-infiltrating lymphocytes (TILs) was analyzed. Of 830 patients, 356 (42.9%) achieved breast pCR, and 324 (39.0%) achieved pCR. The patients with low elasticity values had higher breast pCR and pCR rates than those with high elasticity values. A low E-mean (adjusted odds ratio (OR): 0.620; 95% confidence interval (CI): 0.437 to 0.878;p= 0.007) and low E-max (adjusted OR: 0.701; 95% CI: 0.494 to 0.996;p= 0.047) were independent predictive factors for breast pCR. Low elasticity values were significantly correlated with high TILs. Pretreatment elasticity values measured using SWE were significantly associated with treatment response and inversely correlated with TILs, particularly in HR+HER2- breast cancer and TNBC.
剪切波弹性成像（SWE）是鉴别乳腺癌患者乳腺恶性病灶及腋窝淋巴结转移的有效工具。然而，乳腺癌基线弹性值与新辅助化疗治疗反应之间的关联尚未明确。本研究对2012年1月至2022年12月期间接受新辅助化疗及手术的830例患者进行基线SWE测量，获取平均硬度值（E-mean）与最大硬度值（E-max）。分析弹性值与乳腺病理完全缓解（定义为ypTis/T0）、总体病理完全缓解（定义为ypTis/T0，N0）及肿瘤浸润淋巴细胞（TILs）的相关性。在830例患者中，356例（42.9%）达到乳腺病理完全缓解，324例（39.0%）达到总体病理完全缓解。低弹性值患者的乳腺病理完全缓解率及总体病理完全缓解率均显著高于高弹性值患者。低E-mean值（校正比值比：0.620；95%置信区间：0.437-0.878；p=0.007）与低E-max值（校正比值比：0.701；95%置信区间：0.494-0.996；p=0.047）是乳腺病理完全缓解的独立预测因素。低弹性值与高TILs水平呈显著正相关。SWE测量的治疗前弹性值与治疗反应显著相关，且与TILs呈负相关，尤其在激素受体阳性/人表皮生长因子受体2阴性乳腺癌及三阴性乳腺癌中表现更为明显。
Elasticity Values as a Predictive Modality for Response to Neoadjuvant Chemotherapy in Breast Cancer
肿瘤(癌症)患者之家