ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Cancer Endocrinology
This article is part of the Research TopicAdvancements in Targeted Neoadjuvant and Adjuvant Therapies for Drug-Resistant Breast CancersView all 6 articles
Early Predictive Value of Calcification on Ultrasound and Mammography for Pathological Complete Response to Neoadjuvant Chemotherapy in Breast Cancer and Factors Influencing Tumor Regression
Provisionally accepted
- 1Healthcare Management Center, Department of Critical Care Medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Zhejiang, China
- 2Hangzhou First People's Hospital, Hangzhou, China
- 3Department of Critical Care Medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Zhejiang, China
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Objective: This study aimed to evaluate early predictors of pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) in breast cancer and analyze tumor regression factors by integrating clinicopathological and imaging features. Methods: We retrospectively analyzed the clinical data from 149 breast cancer patients who received neoadjuvant chemotherapy (NAC) at our hospital between January 2021 and January 2023, dividing them into pCR (61) and non-pCR (88) groups. Student's t-test, chi-square test, multivariate logistic regression, and ROC curve analysis assessed pCR-associated factors and the predictive value of ultrasound-mammography combinations. Results: Significant group differences (P<0.05) emerged in imaging features (ultrasound/mammographic calcification characteristics) and clinicopathological markers (clinical stage, T3 status, HER2, Ki67, EGFR). Multivariate analysis identified independent pCR predictors: ultrasound-detected calcifications (OR=15.29), mammographic clustered calcifications (OR=8.63), T3 stage (OR= 12.50), and HER2−/EGFR+ status (OR=7.08), all linked to lower pCR rates. Combined ultrasound-mammography calcification analysis showed a larger AUC (area under ROC curve) than single-modality assessments. Conclusions: Pretreatment ultrasound calcifications, mammographic clustered calcifications, advanced T stage, HER2 negativity, and EGFR positivity correlate with reduced pCR after NAC, indicating poorer prognosis. Ultrasound-mammography combination demonstrates high predictive value for pCR assessment, enhancing NAC response evaluation in breast cancer.
Keywords: breast cancer, Neoadjuvant chemotherapy, breast ultrasound, Mammography, Pathological complete remission, Influencing factors
Received: 21 Jun 2025; Accepted: 29 Oct 2025.
Copyright: © 2025 Wang, Fang and Qu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Li Qu, lilyqu@zuaa.zju.edu.cn
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