Ultrassonografia com Power Doppler como instrumento de avaliação funcional da resposta à quimioterapia no câncer da mama

Abstract

The aim of this study was to evaluate the efficacy of Power Doppler (PD), by quantifying the Vascular Density (Vascularity Index - VI), as a new predictor clinical tool of pathologic response to neoadjuvant chemotherapy in breast cancer, in order to guide the clinician on the effectiveness of chemotherapy as well as the choice of surgical technique by the surgeon. METHOD: For this prospective observational study, 20 patients were recruited with a histological diagnosis of infiltrating breast carcinoma and an indication for neoadjuvant chemotherapy. The tumor vascular density and largest tumor diameter before treatment, after 2 or 3 cycles of chemotherapy and at the end of treatment were evaluated by ultrasound Power Doppler. These findings were compared, and the association with the pathologic response was analyzed. Fisher s exact test, Wilcoxon-Mann-Whitney test, Spearman s correlation coefficient and Pearson s coefficient were used. The sensitivity, specificity and positive and negative predictive values for the histological response were also calculated. P values < 0.05 were considered statistically significant. RESULTS: VI showed a sensitivity of 88.88%, specificity of 100%, positive predictive value of 100% and negative predictive value of 91.66% for the pathologic response, as well as being strongly associated with it. The variation of VI, in terms of either an increase or decrease after 2 or 3 cycles of chemotherapy, significantly predicted the final histological response. CONCLUSION: By quantifying of the VI, PD showed a strong correlation with and predictive power for the histological response to neoadjuvant chemotherapy.