Tissue harmonic imaging sonography of the axillary lymph nodes: evaluation of response to neoadjuvant chemotherapy in breast cancer patients.

Abstract

In breast cancer patients, the number of surgically resected metastatic axillary lymph nodes has been considered to correlate with prognosis. Therefore, the lymph nodes' response to chemotherapy may provide a favorable prognosis by suggesting an appropriate regimen of post-operative chemotherapy. In the present study, we evaluated the therapeutic efficacy of neoadjuvant chemotherapy of the axillary lymph nodes of breast cancer patients, using tissue harmonic imaging ultrasonography. Thirty-three female patients with breast cancer >2 cm in the longest diameter were examined by tissue harmonic imaging both before and following neoadjuvant chemotherapy. Nodes were defined as metastasis positive or negative on the basis of Yang's criteria, at each ultrasonography examination. The ultrasonography findings were correlated with the histopathologic results of the surgically resected specimens. Patients with constantly positive nodes over two ultrasonography examinations had a higher pathological nodes positive rate (8/9, 88.9%) than those (3/10, 30.0%) whose lymph nodes shrunk from the first to second ultrasonography exam (p=0.02, Fisher's exact method). All patients with negative nodes at both ultrasonography examinations had negative pathological results. Thus, changes in consecutive tissue harmonic imaging findings may be used to accurately evaluate the response of axillary lymph nodes to neoadjuvant chemotherapy.