Abstract:

Objective To evaluate the method for predicting breast cancer pathology response through comparisons between application value of physical examination,ultrasound and mammography in measuring the size of tumor before and after chemotherapy and the results of pathological Miller and Payne(MP) grade.Methods 65 patients who received neoadjuvant chemotherapy(NAC) in our department were selected.All patients received one to six cycles of TAC (Docetaxel,Doxorubicin and Cyclophosphamide) regimen or other regimen after being diagnosed as breast cancer by mammotomy biopsy.The following operation was undergone within 3 weeks after the last chemotherapy.The tumor sizes of all patients were examined by physical examination,ultrasound and mammography before NAC and before the operation.The pathological responses were evaluated by MP
grading system criteria by comparing the changes of cancer tissues in biopsy tissues before NAC and after the operation.ROC curve and spearman correlation analysis were used for the analysis between the changes of tumor sizes examined by physical examination,ultrasound and mammography and the results of MP grade．Results There was a significant correlation between MP grade and the results of physicalexamination,ultrasound and mammography (r=0.487,P=0.000;r=0.251,P=0.044;r=0.351,P=0.004 ).The area of pathology complete response (pCR)of MP grade 5 under the ROC curve (Az value) was 0.703 for physical examination,0.531 for ultrasound,0.712 for mammography,and 0.727 for combining three techniques.Conclusion Physical examination and mammography are more useful than ultrasound in predicting the pathologic results of NAC.Combining three techniques has  predictive value in  pathology response of  breast cancer after NAC.

Key words: neoadjuvant chemotherapy；breast neoplasms；Miller and Payne grade