To assess the value of ultrasound combined with mammographic features and Ki-67 index in predicting the efficacy of neoadjuvant chemotherapy for breast cancer.

Sixty-eight patients with breast cancer who received neoadjuvant chemotherapy at Changzhou Second People's Hospital from November 2014 to November 2019 were examined by ultrasonography and mammography before chemotherapy. Pathological and immunohistochemically results were obtained by biopsy. According to the efficacy of neoadjuvant chemotherapy, the patients were divided into either a pathologic complete response (pCR) group or a non-pCR group. Univariate and multivariate Logistic regression analyses were performed to analyze the independent predictors of pCR after neoadjuvant chemotherapy for breast cancer.

Of the 68 patients ,12 achieved pCR and 56 did not, with a pCR rate of 17.6%. The statistically significant parameters identified in the univariate analysis, such as the type of posterior echo of tumor, the edge characteristics of tumor in mammography, and the positive expression rate of Ki-67 or estrogen receptor (ER), were included in binary logistic regression for multivariate analysis. The results showed that absence of posterior shadowing on ultrasound (odds ratio [OR]=0.045, 95% CI: 0.005-0.453), absence of mammographic spiculation (OR=0.128, 95% CI: 0.023-0.720), and high Ki-67 expression (OR=0.045, 95% CI: 0.004-0.546)were independent predictors of pCR.

The absence of posterior shadowing on ultrasound, absence of mammographic speculation, and high Ki-67 high could predict the degree of pathological remission in breast cancer patients after neoadjuvant chemotherapy. Preoperative imaging examination and immunohistochemical Ki-67 detection have appreciated guiding significance for the selection of clinical treatment for breast cancer.