A Study to Correlate Ultrasound Elastography With Histopathology to Monitor the Response of Locally Advanced Breast Cancer to Neoadjuvant Chemotherapy.
This research proposal concerns a study to monitor the effects of chemotherapy on breast
cancer tumour and peritumour stromal cells using ultrasound (US) elastography (also known as
Many cancer treatments currently being developed are targeted; that is they exploit
particular biological processes in specific cancer cell types to disrupt tumour growth.
Being able to monitor the efficacy of these typically high-cost drug therapies is essential
both for the best patient outcome as well as offering economical benefits to the health care
system and much needed insight into future drug development.
Ultrasound provides a relatively inexpensive, non-invasive means for imaging cancers, and
has been used widely in breast cancer diagnosis for many years. Its role in therapy
monitoring has been suggested but has not been well explored. The purpose of this proposal
is to explore this potential in more depth.
It has been identified that significant interaction takes place between tumour and stroma
through all stages of tumour growth; this complex relationship is an ongoing topic of
research. Fibrotic changes occur during tumour growth and are also a quintessential process
of healing. Indeed, fibrosis is a common after effect to chemotherapy in many forms of
cancer. Elastography is an established imaging technique (based on ultrasound or MRI) which
can estimate the relative stiffness of tissues in vivo and is thus well-suited to monitor
these particular biological processes.
This elucidates the main hypothesis of this project: fibrosis, cancer cell necrosis and
inflammation may all contribute to a measurable response in elastography. These changes to
the tissue composition can be imaged over a course of a patient's treatment to assess the
response to chemo/hormonal therapy.
The ultimate project goals are to develop a clinical tool (based on ultrasound elastography)
to improve treatment management in addition to offering a better biological understanding of
Observational Model: Case-Only, Time Perspective: Retrospective
The ratio of average stiffness measured within the tumour over average stiffness measured in the stroma
Tissue stiffness will be used to assess a patients response to chemotherapy
Patients will be followed over the course of chemotherapy treatment, an expected average of 18 weeks
Ruth English, M.D.
Oxford University NHS Trust
United Kingdom: National Health Service