Skip to main content

Advertisement

SpringerLink
Log in

Color doppler ultrasound as an objective assessment tool for chemotherapeutic response in advanced breast cancer

  • Original Article
  • Published:
Breast Cancer Aims and scope Submit manuscript

Abstract

Background

In our part of the world, the majority of the patients with breast cancer present with locally advanced disease and require neo-adjuvant chemotherapy as the primary treatment modality. It is essential to monitor the response to chemotherapy in these patients. Clinical examination as the sole criterion of response assessment is entirely subjective and fallacious. Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) are expensive. The role of Doppler ultrasonography as an imaging modality for this purpose is therefore being evaluated.

Methods

A prospective study was undertaken of 25 cases of locally advanced breast carcinoma (LABC) and Color Doppler sonography was used for the sequential assessment of chemotherapeutic response. The response assessed on the basis of clinical examination and Color Doppler was compared with the histological response. The parameters assessed on color Doppler were a change in the number of flow signals, maximum flow velocity (Vmax), pulsatility index (PI) and resistivity index (RI). Responses were analysed statistically using the Pearson correlation coefficient and Kappa statistics (κ). The sensitivity, specificity, positive predictive & negative predictive values for predicting complete histological response were calculated.

Results

Color Doppler showed a sensitivity of 88.88% for predicting complete histological response. The negative predictive value of color Doppler was 92.3%. A significant correlation was obtained between color Doppler & histopathological response.

Conclusions

Color Doppler was found to be an objective and effective tool or modality compared with clinical evaluation in sequential response assessment, especially for predicting complete histological response.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Parkin DM, Whelon SL, Ferlay J,et al: Cancer incidence in five continents. No 143. Vol VII. Lyons, France; International Agency for Research on Cancer Scientific Publications, 1997.

    Google Scholar 

  2. Newman LA: Management of patients with locally advanced breast cancer.Curr Oncol Rep 6:53–61, 2004.

    Article  PubMed  Google Scholar 

  3. Dixon JM, Senbanjo RO, Anderson TJ, Forrest AP, Elton RA: Clinical assessment of tumour size in primary breast carcinoma.Clin Oncol 10:117–121, 1984.

    PubMed  CAS  Google Scholar 

  4. Forouhi P, Walsh JS, Anderson TJ, Chetty U: Ultrasonography as a method of measuring breast tumour size and monitoring response to primary systemic treatment.Br J Surg 81:223–225, 1994.

    Article  PubMed  CAS  Google Scholar 

  5. Fornage BD, Toubas O, Morel M: Clinical, mammographic, and sonographic determination of preoperative breast cancer size.Cancer 60:765–771, 1987.

    Article  PubMed  CAS  Google Scholar 

  6. Hayward JL, Carbone PP, Heuson JC, Kumaoka S, Segaloff A, Rubens RD: Assessment of response to therapy in advanced breast cancer. A project of the programme on clinical oncology of the UICC.Eur J Cancer 14:1291–1292, 1978.

    PubMed  CAS  Google Scholar 

  7. Warr D, McKinney S, Tannock I: Influence of measurement error on assessment of response to anticancer chemotherapy: proposal for new criteria of tumor response.J Clin Oncol 2:1040–1046, 1984.

    PubMed  CAS  Google Scholar 

  8. Fiorentino C, Berruti A, Bottini A, Bodini M, Brizzi MP,et al: Accuracy of mammography and echography versus clinical palpation in the assessment of response to primary chemotherapy in breast cancer patients with operable disease.Breast Cancer Res Treat 69:143–151, 2001.

    Article  PubMed  CAS  Google Scholar 

  9. Huber S, Medl M, Helbich T, Taucher S, Wagner T,et al: Locally advanced breast carcinoma: Computer assisted semi quantitative analysis of Color Doppler ultrasonography in the evaluation of tumor response to neoadjuvant chemotherapy.J Ultrasound Med 19:601–607, 2000.

    PubMed  CAS  Google Scholar 

  10. Landis JR, Koch GG: The measurement of observer agreement for categorical data.Biometrics 33:159–174, 1977.

    Article  PubMed  CAS  Google Scholar 

  11. Mansi JL, Smith JE, Walsh G, A’Hem RP, Hammer CL,et al: Primary medical therapy for operable breast cancer.Eur J Cancer Clin Oncol 25:1623–1627, 1989.

    Article  PubMed  CAS  Google Scholar 

  12. Feldman LD, Hortobagyi GN, Buzdar AV, Ames FC, Blumenschein GR: Pathological assessment of response to induction chemotherapy in breast cancer.Cancer Res 46:2578–2581, 1986.

    PubMed  CAS  Google Scholar 

  13. Cocconi G, Di Blasio B, Alberti G, Bisagni G, Botti E, Peracchia G: Problems in evaluating response of primary breast cancer to systemic therapy.Breast Cancer Res Treat 4:309–313, 1984.

    Article  PubMed  CAS  Google Scholar 

  14. Knopp MV, Brix G, Junkermann HJ, Sinn HP: MR mammography with pharmacokinetic mapping for monitoring breast cancer treatment during neoadjuvant therapy.MRI Clin North Am 2:633–658, 1994.

    CAS  Google Scholar 

  15. Lagalla R, Caruso G, Finazzo M: Monitoring treatment response with Color and power Doppler.Eur J Radiol 27 (Suppl 2):S149–156, 1998.

    Article  Google Scholar 

  16. Kedar RP, Cosgrove DO, Bamber JC, Bell DS: Automated quantification of Color Doppler signals. A preliminary study in breast tumors.Radiology 197:39–43, 1995.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of General Surgery, Institute of medical Sciences, Banaras Hindu University, 221005, Varanasi, India

    Seema Singh, Mumtaz Ahmad Anson & Anand Kumar

  2. Department of Radiotherapy, Institute of Medical Sciences, Banaras Hindu University, 221005, Varanasi, India

    Satyajit Pradhan

  3. Department of Radiodiagnosis, Institute of Medical Sciences, Banaras Hindu University, 221005, Varanasi, India

    Ram Chandra Shukla

Authors
  1. Seema Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Satyajit Pradhan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ram Chandra Shukla
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mumtaz Ahmad Anson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Anand Kumar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anand Kumar.

About this article

Cite this article

Singh, S., Pradhan, S., Shukla, R.C. et al. Color doppler ultrasound as an objective assessment tool for chemotherapeutic response in advanced breast cancer. Breast Cancer 12, 45–51 (2005). https://doi.org/10.2325/jbcs.12.45

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.2325/jbcs.12.45

Key words

Search

Navigation