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Peer-reviewedCC BY 4.0Frontiers in Oncology

Assessment of shear wave elastography for evaluating neoadjuvant chemotherapy efficacy in breast cancer: correlation of stiffness changes with pathological response

  • Hongying Yang1
  • Shan Liu2
  • Xiaomao Luo1
  • Zeng Zhang2
  • Qin Su3
  • Wenjing Pu4
  • Haitao Chen1
  • Qian An2
  • Xin Liu5
  • Likun Luan6
  • Ningxin Zhang7
  • Peijun Yao8
5 more authors
  • Yingxian Zhang1
  • Lei Zhang1
  • Jie Yu1
  • Zhiyao Li1
  • Zhirui Chuan1
8 affiliations
  1. 1Department of Ultrasound, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Peking University Cancer Hospital Yunnan
  2. 2Department of Integrated Traditional Chinese and Western Medicine, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Peking University Cancer Hospital Yunnan
  3. 3Department of Otolaryngology, Kunming First People’s Hospital
  4. 4Yunnan Institute of Traditional Chinese Medicine, Yunnan University of Chinese Medicine
  5. 5Department of Pathology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Peking University Cancer Hospital Yunnan
  6. 6Department of Gastric and Small Intestinal Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Peking University Cancer Hospital Yunnan
  7. 7Department of Thyroid and Breast Surgery Department, The Second Affiliated Hospital of Kunming Medical University
  8. 8Department of Colorectal Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Peking University Cancer Hospital Yunnan
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Abstract

Background: Accurate evaluation of neoadjuvant chemotherapy (NAC) efficacy is critical for optimizing breast cancer treatment. This study investigates shear wave elastography (SWE) for quantifying stiffness changes within lesions and peri-lesional tissues (1–3 mm) and correlating these changes with pathological response to NAC.

Methods: In a prospective cohort of 66 breast cancer patients, SWE parameters (Emax, Emean, Emin, Esd) were measured within tumors and surrounding tissues (1/2/3 mm) pre- and post-NAC. Pathological response was classified via Miller-Payne grading (G3-G5: effective; G1-G2: ineffective). Diagnostic performance was assessed using ROC curves.

Results: Post-NAC, the effective group exhibited significant reductions in Emax, Emean, and Esd within lesions and peri-lesional regions (all P < 0.05), while the ineffective group maintained high stiffness. ΔEmax showed high apparent discrimination of pathological response: Intralesional ΔEmax: AUC = 0.941 (95% CI: 0.887-0.995), sensitivity 88.89%, specificity 85.71% (cutoff >49.12%). Peri-lesional ΔEmax (1–3 mm): AUC > 0.9, specificity >90%. The stiff rim sign disappeared exclusively in the effective group post-NAC.

Conclusion: SWE parameters (especially ΔEmax) and dynamic changes in the stiff rim sign are promising non-invasive biomarkers that correlate with pathological response to NAC. These findings support the potential role of SWE in post-treatment response evaluation, though prospective validation in larger cohorts is warranted before clinical implementation.

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Cite

BibTeXRIS
BibTeX
@article{yang2026assessment,
  title = {{Assessment of shear wave elastography for evaluating neoadjuvant chemotherapy efficacy in breast cancer: correlation of stiffness changes with pathological response}},
  author = {Hongying Yang and Shan Liu and Xiaomao Luo and Zeng Zhang and Qin Su and Wenjing Pu and Haitao Chen and Qian An and Xin Liu and Likun Luan and Ningxin Zhang and Peijun Yao and Yingxian Zhang and Lei Zhang and Jie Yu and Zhiyao Li and Zhirui Chuan},
  journal = {Frontiers in Oncology},
  year = {2026},
  month = oct,
  doi = {10.3389/fonc.2026.1839381},
  url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1839381/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Assessment of shear wave elastography for evaluating neoadjuvant chemotherapy efficacy in breast cancer: correlation of stiffness changes with pathological response
AU  - Hongying Yang
AU  - Shan Liu
AU  - Xiaomao Luo
AU  - Zeng Zhang
AU  - Qin Su
AU  - Wenjing Pu
AU  - Haitao Chen
AU  - Qian An
AU  - Xin Liu
AU  - Likun Luan
AU  - Ningxin Zhang
AU  - Peijun Yao
AU  - Yingxian Zhang
AU  - Lei Zhang
AU  - Jie Yu
AU  - Zhiyao Li
AU  - Zhirui Chuan
PY  - 2026
DA  - 2026/10/26
JO  - Frontiers in Oncology
DO  - 10.3389/fonc.2026.1839381
UR  - https://www.frontiersin.org/articles/10.3389/fonc.2026.1839381/full
AB  - Background: Accurate evaluation of neoadjuvant chemotherapy (NAC) efficacy is critical for optimizing breast cancer treatment. This study investigates shear wave elastography (SWE) for quantifying stiffness changes within lesions and peri-lesional tissues (1–3 mm) and correlating these changes with pathological response to NAC.  Methods: In a prospective cohort of 66 breast cancer patients, SWE parameters (Emax, Emean, Emin, Esd) were measured within tumors and surrounding tissues (1/2/3 mm) pre- and post-NAC. Pathological response was classified via Miller-Payne grading (G3-G5: effective; G1-G2: ineffective). Diagnostic performance was assessed using ROC curves.  Results: Post-NAC, the effective group exhibited significant reductions in Emax, Emean, and Esd within lesions and peri-lesional regions (all P < 0.05), while the ineffective group maintained high stiffness. ΔEmax showed high apparent discrimination of pathological response: Intralesional ΔEmax: AUC = 0.941 (95% CI: 0.887-0.995), sensitivity 88.89%, specificity 85.71% (cutoff >49.12%). Peri-lesional ΔEmax (1–3 mm): AUC > 0.9, specificity >90%. The stiff rim sign disappeared exclusively in the effective group post-NAC.  Conclusion: SWE parameters (especially ΔEmax) and dynamic changes in the stiff rim sign are promising non-invasive biomarkers that correlate with pathological response to NAC. These findings support the potential role of SWE in post-treatment response evaluation, though prospective validation in larger cohorts is warranted before clinical implementation.
SN  - 2234-943X
ER  -