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

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.