Breast Imaging| Volume 55, P41-46, May 2019

Ultrasound echogenicity reveals the response of breast cancer to chemotherapy


      • The alteration of the echogenicity of breast cancer tumors during NAC correlated with pathological response.
      • Persistent tumor hypoechogenicity after 3 courses of NAC predicts a poor response to treatment.
      • Lesion size and elasticity were important factors in predicting response to NAC.



      To evaluate the ultrasound (US) response in patients with breast cancer (BC) during neoadjuvant chemotherapy (NAC).


      Prospective US analysis was performed on 19 malignant tumors prior to NAC treatment and 7 days after each first four courses of NAC in 13 patients (median age = 57 years). Echogenicity, size, vascularity, and sonoelastography were measured and compared with posttreatment scores of residual cancers burden.


      Changes in the echogenicity of tumors after 3 courses of NAC had the most statistically strong correlation with the percentage of residual malignant cells used in histopathology to assess the response to treatment (odds ratio = 60, p < 0.05). Changes in lesion size and elasticity were also significant (p < 0.05).


      There is a statistically significant relationship between breast tumors' echogenicity in US, neoplasm size, and stiffness and the response to NAC. In particular, our results show that the change in tumor echogenicity could predict a pathological response with satisfactory accuracy and may be considered in NAC monitoring.


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