PREDICTION OF EARLY CHEMOTHERAPY-RESPONSE IN PRIMARY BREAST CANCER BY DOPPLER ULTRASOUND

Problemstellung: Primary systemic chemotherapy became a widely used approach in breast cancer treatment. In this setting tumor response is a major focus of interest. Tumor growth and regression are directly correlated to tumor vascularisation, which can be assessed by Doppler ultrasound. We hypothesized that breast cancer vascularisation changes under chemotherapy. We analyzed if Doppler-ultrasound is the favorable method to detect tumor response over measurement of tumor size by regular ultrasound.

Methoden: 21 patients with histologically confirmed breast cancer and treatment by primary systemic chemotherapy were included during a 10 month period. The tumor diameter was determined by ultrasound before the first cycle. At the same time the number of tumor vessels was detected by color coded Doppler ultrasound. These measurements were repeated three weeks later. These two parameters were correlated to the histo-pathological tumor response (complete-, partial- response, stable-, progressive- disease) after surgery.

Ergebnisse: Until now 17 patients finished chemotherapy and underwent surgery. A complete response (CR) was observed in 5, a partial response (PR) in 11 and a stable disease (SD) in one patient. In the CR group the tumor diameter regressed by 25% (from a mean value of 2,1cm to 1,6cm) after the first chemotherapy infusion compared to 33% in the PR group (from 3,4cm to 2,3cm) in average. The number of tumor vessels decreased by 17% (from a mean value of 6,9 vessels to 5,8) in the CR and by 21% in the PR group (from 9,8 vessels to 7,7 in average) during the same treatment period.

Schlussfolgerungen: Measurement of breast cancer vascularisation by color coded Doppler ultrasound showed no advantage compared to the measurement of the tumor diameter. Our results did not show a larger reduction of tumor vascularisation or tumor diameter in the CR group compared to the PR group. Our findings suggest that both parameters have only a minor relevance in the early prediction of tumor response to primary chemotherapy in breast cancer.