Abstract Background: Predicting response to NAST may help tailor treatment, maximize pCR rates and de-escalate surgery (BCS, SLNB). We tested if multiparametric imaging- using mammography breast tomosynthesis (DBT), ultrasound shear wave elastography (SWE) 0.0001); 92% patients with pCR had decreased density. Density post2NAST was strongly associated with response- 87% low-density tumors had low RCB (0-1), c.w. 88% persistent high-density tumors had poor response (RCB 2-3)- 87% sensitivity, 80% specificity. Post2NAST, ≥17.6% reduction in max diam predicted pCR with 82.5% sensitivity, 70% specificity (AUC = 0.817), while ≥39.4% vol. reduction predicted pCR with 87.5% sensitivity, 70% specificity (AUC = 0.824). Mean 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS2-01-13.
Agarwal et al. (Tue,) studied this question.