A Risk Model based on Ultrasound, Ultrasound Elastography, and Histologic Parameters for Predicting Axillary Lymph Node Metastasis in Breast Invasive Ductal Carcinoma

Xiao-Long Li,Bo-Ji Liu,Ya-Ping He,Dan-Dan Li,Hui-Xiong Xu,Li-Ping Sun,Lin Fang,Wen-Wen Yue,Jun-Mei Xu

doi:10.1038/s41598-017-03582-3

Abstract

To develop a risk model for predicting axillary lymph node metastasis (LNM) in patients with breast invasive ductal carcinoma (IDCs) using ultrasound (US), US elastography of virtual touch tissue imaging (VTI) and virtual touch tissue imaging & quantification (VTIQ), and histologic parameters. This study included 162 breast IDCs in 162 patients. Univariate and multivariate analyses were used to identify the risk factors and a risk model was created. The results found that 64 (39.5%) of 162 patients had axillary LNMs. The risk score (RS) for axillary LNM was defined as following: RS = 1.3 × (if lesion size ≥20 mm) + 2.6 × (if taller than wide shape) + 2.2 × (if VTI score ≥5) + 3.9 × (if histological grade III) + 1.9 × (if positive C-erbB-2). The rating system was divided into 6 stages (i.e. Stage I, Stage II, Stage III, Stage IV, Stage V, and Stage VI) and the associated risk rates in terms of axillary LNM were 0% (0/19), 6.1% (2/33), 7.7% (3/39), 65.5% (19/29), 92.3% (24/26), and 100% (16/16), respectively. The risk model for axillary LNM established in the study may facilitate subsequent treatment planning and management in patients with breast IDCs.

Highlights

Breast cancer has become a global health problem and caused more and more death in females in recent years
Many studies have showed that breast cancers are stiffer than normal and benign tissues[10,11,12], which can be evaluated by US elastography
We hypothesized that virtual touch tissue imaging (VTI) and virtual touch tissue imaging & quantification (VTIQ) might be useful for predicting axillary lymph node metastasis (LNM)

Summary

Introduction

Breast cancer has become a global health problem and caused more and more death in females in recent years. New US-based elastography techniques, acoustic radiation force impulse (ARFI) imaging of virtual touch tissue imaging (VTI; Siemens Medical Solutions, Mountain View, CA, USA) and shear wave imaging of virtual touch tissue imaging & quantification (VTIQ; Siemens Medical Solutions, Mountain View, CA, USA) have recently been used to diagnose breast cancers by measurement of the tissue stiffness[10, 11]. The purpose of the present study was to identify the risk factors including conventional US, VTI, VTIQ, and the histologic parameters and to propose a new risk model for predicting axillary LNM in patients with breast IDCs

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Results

Conclusion