Doppler ultrasound predicts chemotherapy success for breast cancer

Doppler ultrasound breast tumor exams conducted prior to chemotherapy can reliably predict the outcome of treatment, according to research conducted in India. Most breast cancer is treated with chemotherapy prior to surgery. The traditional way to assess the success of this chemotherapy is to study tissue samples collected at surgery. In this study, researchers developed a scoring method using Doppler ultrasound to predict chemotherapy success.

Dr. Anand Kumar and colleagues in the Institute of Medical Sciences at Banaras Hindu University in Varanasi, India, published the results of their study in the Aug. 28 issue of the World Journal of Surgical Oncology. They studied 50 women with locally advanced infiltrating ductal carcinoma. Mean age was 44.5 years.

Each patient started with three examinations: a standard clinical exam, histopathological assessment of biopsied tissue, and Doppler ultrasound investigation of blood flow to the tumor. Patients then proceeded through three cycles of chemotherapy. After the last round of chemotherapy, another Doppler ultrasound exam was performed, followed by surgery.

Tumor characteristics on the Doppler ultrasound exams were graded on a standardized system of 1 to 4, corresponding to <25%, 25%, 50%, and >50% disappearance of flow signals, respectively. A low score meant less change between the first and second ultrasound exams. A cumulative score was calculated and compared with histopathological results from surgery. The highest score possible was 12 and the lowest 3.

In all cases, higher Doppler scores corresponded with a more favorable response assessed histopathologically. Among the 50 patients in the study, 24 had a complete response to chemotherapy. Of these 24 patients, 16 of them, or 66.7%, had a Doppler ultrasound score higher than 9. A cumulative score higher than 5 was shown to have 91.7% sensitivity and 38.5% specificity.

The researchers concluded that Doppler ultrasound scoring can be used to predict accurately the outcome of chemotherapy, at least in patients with locally advanced breast cancer.