Can shear-wave elastography predict response to neoadjuvant chemotherapy in women with invasive breast cancer?

A Evans, S Armstrong, P Whelehan, K Thomson, P Rauchhaus, C Purdie, L Jordan, L Jones, A Thompson, S Vinnicombe, A Evans, S Armstrong, P Whelehan, K Thomson, P Rauchhaus, C Purdie, L Jordan, L Jones, A Thompson, S Vinnicombe

Abstract

Background: Response of invasive breast cancer to neoadjuvant chemotherapy (NAC) is variable, and prediction of response is imperfect. We aimed to ascertain whether tissue stiffness in breast cancers, as assessed by shear-wave elastography (SWE) before treatment, is associated with response.

Methods: We retrospectively compared pre-treatment tumour mean tissue stiffness, with post-treatment Residual Cancer Burden (RCB) scores and its components in 40 women with breast cancer treated by NAC using Pearson's correlation coefficient (CC), a general linear model and multiple linear regression. Subgroup analysis was carried out for luminal, HER2-positive and basal immuno-histochemical subtypes.

Results: Statistically significant correlations were shown between stiffness and RCB scores and between stiffness and percentage tumour cellularity. The correlation between stiffness and percentage cellularity was strongest (CC 0.35 (P<0.0001) compared with CC 0.23 (P=0.004) for the RCB score). The results of a general linear model show that cellularity and RCB score maintain independent relationships with stiffness. By multiple linear regression, only cellularity maintained a significant relationship with stiffness.

Conclusion: Pre-treatment tumour stiffness measured by SWE, has a statistically significant relationship with pathological response of invasive breast cancer to NAC.

Figures

Figure 1
Figure 1
Shear-wave elastography image showing a 2 mm ROI placed over the stiffest region on this image of a cancer from the study. The mean stiffness value was 125 kPa and the RCB score after chemotherapy was 0.
Figure 2
Figure 2
Relationship between pre-treatment mean stiffness and post-treatment RCB score.
Figure 3
Figure 3
Relationship between pre-treatment mean stiffness and percentage residual cellularity after treatment.

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