Mapeamento power Doppler do câncer de mama em pacientes sob quimioterapia neoadjuvante segundo os subtipos tumorais intrínsecos

Abstract

Introduction: Vascular changes and changes in the image, magnetic resonance imaging (MRI) during neoadjuvant chemotherapy (QTN), have been reported to predict pathological response (PR) in breast cancer breast .Tumors with the same histological types , stages and degrees of differentiation may have different outcomes in relation to prognostic factors and responses to established treatments. Moreover, molecular subtypes respond differently to neoadjuvant chemotherapy. Objective: To evaluate the accuracy of power Doppler (PD) mapping method as a predictor of pathological response in breast cancer, compared to chemotherapy neoadjuvant towards triple negative tumor (TN) subtypes, positive homonal receptor (HR +) and HER2 negative (HER2-) and HER2 positive (HER2+). Methods: Included patients with LABC treated at the Hospital of the UFU. All were subjected to Power Doppler ultrasonography before, after 2-3 cycles and at the end of chemotherapy. Tumor diameters were measured and calculated the rate of vascularization of the tumor mass by the PD. Were classified as responders those who had complete reduction to or greater than 30% of the initial vasculature and diameters. Non-responder that patients with lower than 30% reductions or increases less than 20% or greater increase of 20% compared to the initial evaluation. Tumor subtypes were identified and associated with response patterns. Spearman test was used with p = 0.05. Results: 40 patients enrolled and 26 completed in cases. After 2 or 3 cycles of the VPN QTN was 75% overall, 60% in TN in HER2 + 100% and 80% in RH + HER2 -. The accuracy even this time was 73.91% overall and TN subtypes HER2 + RH + and HER2- was 57.14%, 75% and 83.33% respectively. At the end of chemotherapy general VPN was 92.85% and 83.33%, 100% and 100% for subtypes TN, HER2 + and RH + HER2-, respectively; accurately at the end of treatment 92% of the overall assessment, and 87.50%, 80% and 100% for TN subtypes HER2 + and RH+ HER2-, respectively, when evaluated separately. Conclusion: It appears that ultrasound with power Doppler can be an important tool for evaluation of response to neoadjuvant chemotherapy and its association with breast tumor subtypes can aid in predicting response to chemotherapy and surgical planning in assessing whether or not a conservative surgery.