An ultrasound-based model for predicting the response to neoadjuvant chemotherapy in early stage triple negative breast cancer patients

Abstract Background The accurate identification of patients with triple negative breast cancer (TNBC) likely to achieve pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) holds significant clinical value. The aim of this study was to establish a prediction model that incorporate...

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Main Authors: Yuyang Tong, Yi Wei, Peixuan Sun, Cai Chang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Medical Imaging
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Online Access:https://doi.org/10.1186/s12880-025-01818-7
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author Yuyang Tong
Yi Wei
Peixuan Sun
Cai Chang
author_facet Yuyang Tong
Yi Wei
Peixuan Sun
Cai Chang
author_sort Yuyang Tong
collection DOAJ
description Abstract Background The accurate identification of patients with triple negative breast cancer (TNBC) likely to achieve pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) holds significant clinical value. The aim of this study was to establish a prediction model that incorporate clinical data and ultrasound features to predict pCR among TNBC patients as early as possible after the initial two NAC cycles. Methods From January 2016 to December 2021, a total of 262 patients were recruited and divided into training and validation groups at a 7:3 ratio. Both univariate and multivariate logistic regression analyses were conducted to identify independent factors predicting pCR in the training group. Subsequently, a nomogram integrating the predictive factors was established and applied to the validation group. The performance of this model was assessed based on its discrimination, calibration and clinical utility. Results The nomogram that incorporated patient age, clinical T stage, posterior echo enhancement and tumor volume reduction showed robust performance. It achieved an area under curve (AUC) of 0.818, and recorded sensitivity, specificity, and accuracy of 65.2%, 82.5%, and 75.0% respectively in the training group. In the validation group, the model scored an AUC of 0.776, with sensitivity, specificity, and accuracy of 85.7%, 66.7%, and 73.4%, respectively. The decision curve analysis further indicated that the model provided more benefit than standard treat-all or treat-none approaches in predicting pCR. Conclusion This prediction model may assist in predicting pCR to NAC among patients with TNBC, enabling an optimal treatment management in clinical practice. Trial registration Not applicable.
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spelling doaj-art-65bcb67de3654df3a583263bbe4efbb62025-08-20T03:06:29ZengBMCBMC Medical Imaging1471-23422025-07-0125111510.1186/s12880-025-01818-7An ultrasound-based model for predicting the response to neoadjuvant chemotherapy in early stage triple negative breast cancer patientsYuyang Tong0Yi Wei1Peixuan Sun2Cai Chang3Department of Ultrasound, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan UniversityDepartment of Ultrasound, Ruijin Hospital, Shanghai Jiaotong University School of MedicineDiagnostic Imaging Center, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Ultrasound, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan UniversityAbstract Background The accurate identification of patients with triple negative breast cancer (TNBC) likely to achieve pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) holds significant clinical value. The aim of this study was to establish a prediction model that incorporate clinical data and ultrasound features to predict pCR among TNBC patients as early as possible after the initial two NAC cycles. Methods From January 2016 to December 2021, a total of 262 patients were recruited and divided into training and validation groups at a 7:3 ratio. Both univariate and multivariate logistic regression analyses were conducted to identify independent factors predicting pCR in the training group. Subsequently, a nomogram integrating the predictive factors was established and applied to the validation group. The performance of this model was assessed based on its discrimination, calibration and clinical utility. Results The nomogram that incorporated patient age, clinical T stage, posterior echo enhancement and tumor volume reduction showed robust performance. It achieved an area under curve (AUC) of 0.818, and recorded sensitivity, specificity, and accuracy of 65.2%, 82.5%, and 75.0% respectively in the training group. In the validation group, the model scored an AUC of 0.776, with sensitivity, specificity, and accuracy of 85.7%, 66.7%, and 73.4%, respectively. The decision curve analysis further indicated that the model provided more benefit than standard treat-all or treat-none approaches in predicting pCR. Conclusion This prediction model may assist in predicting pCR to NAC among patients with TNBC, enabling an optimal treatment management in clinical practice. Trial registration Not applicable.https://doi.org/10.1186/s12880-025-01818-7Pathological complete responseNeoadjuvant chemotherapyTriple negative breast cancerUltrasoundNomogram
spellingShingle Yuyang Tong
Yi Wei
Peixuan Sun
Cai Chang
An ultrasound-based model for predicting the response to neoadjuvant chemotherapy in early stage triple negative breast cancer patients
BMC Medical Imaging
Pathological complete response
Neoadjuvant chemotherapy
Triple negative breast cancer
Ultrasound
Nomogram
title An ultrasound-based model for predicting the response to neoadjuvant chemotherapy in early stage triple negative breast cancer patients
title_full An ultrasound-based model for predicting the response to neoadjuvant chemotherapy in early stage triple negative breast cancer patients
title_fullStr An ultrasound-based model for predicting the response to neoadjuvant chemotherapy in early stage triple negative breast cancer patients
title_full_unstemmed An ultrasound-based model for predicting the response to neoadjuvant chemotherapy in early stage triple negative breast cancer patients
title_short An ultrasound-based model for predicting the response to neoadjuvant chemotherapy in early stage triple negative breast cancer patients
title_sort ultrasound based model for predicting the response to neoadjuvant chemotherapy in early stage triple negative breast cancer patients
topic Pathological complete response
Neoadjuvant chemotherapy
Triple negative breast cancer
Ultrasound
Nomogram
url https://doi.org/10.1186/s12880-025-01818-7
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