Objective:

To evaluate the effectiveness of ultrasound (US) as a predictor of pathological response to neoadjuvant chemotherapy (NAC) in breast cancer patients through a systematic review and meta-analysis.

Key Findings:

• A total of 72 studies involving 8439 patients were included in the analysis.
• The studies reported various ultrasound techniques including grayscale, Doppler, contrast-enhanced, and elastography.
• The pathological response rate varied significantly across studies, from 14.1% to 83.9%.

Interpretation:

Ultrasound shows potential as a reliable predictor of pathological response to NAC in breast cancer, but results are inconsistent across studies, necessitating further investigation.

Limitations:

• High risk of bias in patient selection and index test across many studies.
• Variability in ultrasound techniques and definitions of pathological response.

Conclusion:

Ultrasound may serve as a valuable tool in predicting pathological response to NAC in breast cancer, but further standardization and research are needed to enhance its predictive accuracy.