Predictive value of multimodal ultrasound imaging and BCL-2 expression levels in the outcome of neoadjuvant chemotherapy for breast cancer

A cohort of 60 breast cancer patients undergoing neoadjuvant chemotherapy (NAC) from January 2021 to December 2022 was studied at the First Affiliated Hospital of Xinjiang Medical University. Multimodal ultrasound examinations were conducted before and after NAC. Levels of B-lymphocytoma-2 (BCL-2) and Ki-67 were assessed through immunohistochemistry both before NAC and during radical mastectomy. Based on the Miller-Payne system, the efficacy of NAC in these patients was categorized into pathologic complete remission (pCR) and non-complete remission (npCR). It was found that: Pathological evaluation postoperatively revealed that 26 patients achieved pCR, while 34 experienced npCR following NAC. In both pCR and npCR groups, significant reductions in lesion diameter, peak intensity (PI), area under the curve (AUC) and elasticity score were observed post-NAC, as well as an increase in Strain Ratio (SR). These changes were more pronounced in the pCR group, with statistically significant differences (p < 0.05). Post-NAC, an increase in BCL-2 and a decrease in Ki-67 expression were observed in both groups, although these changes were not statistically significant (p > 0.05). Receiver operating characteristic (ROC) curves and multifactorial regression analysis identified lesion diameter, PI and AUC as significant predictors of NAC efficacy in breast cancer patients.

Breast cancer; Neoadjuvant chemotherapy; Multimodal ultrasound; BCL-2; Complete remission; ROC curves

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