AUTHOR=Cui Hao , Han Peng , Zhao Dantong , Zhang Xudong , Wang Ying , Kong Hanqing , Peng Fuhui , Tian Wei J., Zhang Lei 

TITLE=Predicting Pathological Complete Response After Neoadjuvant Chemotherapy in Advanced Breast Cancer by Ultrasound and Clinicopathological Features Using a Nomogram

JOURNAL=Frontiers in Oncology

VOLUME=Volume 11 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.718531

DOI=10.3389/fonc.2021.718531

ISSN=2234-943X

ABSTRACT=Background and Aims: Prediction of pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) for breast cancer is critical for surgical planning and evaluation of NAC efficacy. The purpose of this project was to assess the efficiency of a novel nomogram based on ultrasound and clinicopathological features for predicting pCR after NAC.
Methods: This retrospective study included 282 patients with advanced breast cancer from two centers treated with NAC. Patients received breast ultrasound before NAC and after two-cycles of NAC, and we recorded the ultrasound, clinicopathological features and feature changes after two-cycles of NAC. A multivariable logistic regression model combined with bootstrapping screened for informative features associated with pCR. Then, we constructed two nomograms, an initial-baseline nomogram and a two-cycle response nomogram. Sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) were analyzed. The C-index was used to evaluate predictive accuracy.
Results: Sixty (60/282, 21.28%) patients achieved pCR. TNBC and HER-2 amplified types were more likely to obtain pCR. Size shrinkage, posterior acoustic pattern and elasticity score were identified as independent factors by multivariate logistic regression. In the validation cohort, the two-cycles response nomogram showed better discrimination than the initial-baseline nomogram, with the C-index reaching 0.79. The sensitivity, specificity and NPV of the two-cycles response nomogram were 0.77, 0.77 and 0.92, respectively.
Conclusion: The two-cycles response nomogram exhibited satisfactory efficiency, which means that the nomogram was a reliable method to predict pCR after NAC. Size shrinkage after two-cycles of NAC was an important dependent factor in predicting pCR.