Association of conventional ultrasound, elastography and clinicopathological factors with axillary lymph node status in invasive ductal breast carcinoma with sizes > 10 mm.

Hui Liu,Ming-Hua Yao,Yan Fang,Rong Wu,Li-Hua Xiang,Guang Xu,Huan Pu

doi:10.18632/oncotarget.18969

Abstract

BackgroundTo evaluate whether conventional ultrasound, elastography [conventional strain elastography of elasticity imaging, acoustic radiation force impulse induced strain elastography of virtual touch tissue imaging, and a novel two-dimensional shear wave elastography of virtual touch tissue imaging quantification] and clinicopathological factors are associated with axillary lymph node metastasis in invasive ductal breast carcinoma with sizes > 10 mm.Materials and MethodsWe evaluated 150 breast lesions from 148 patients using the above methods and the clinicopathological factors. Univariate and multivariate logistic regression analysis were performed to determine the axillary lymph node metastasis risk factors. Diagnostic performance was evaluated using receiver operating characteristic curve analysis.ResultsSixty-three tumors (42%) were node-positive, 87 (58%) were node-negative. Aspect ratio, virtual touch tissue imaging grade, shear wave velocity, pathological invasive tumor size, and histological grade maintained independent significance in predicting nodal involvement. The mean tumor shear wave velocitys (4.60, 6.49, 7.16) increased in proportion to metastatic node number (0, 1–3, ≥ 4, respectively; P < 0.001). For all tumors in this study, the cut-off shear wave velocity was 6.16 m/s and was associated with 64.1% sensitivity, 78.0% specificity and an area under the ROC curve of 0.799 (95% confidence interval, 0.731–0.868).ConclusionsAspect ratio, virtual touch tissue imaging grade, shear wave velocity, pathological invasive tumor size and histological grade are independently associated with axillary lymph node metastasis in invasive ductal breast carcinoma with sizes > 10 mm.

Highlights

Breast cancer is the most frequent cancer in women worldwide [1]
To evaluate whether conventional ultrasound, elastography [conventional strain elastography of elasticity imaging, acoustic radiation force impulse induced strain elastography of virtual touch tissue imaging, and a novel twodimensional shear wave elastography of virtual touch tissue imaging quantification] and clinicopathological factors are associated with axillary lymph node metastasis in invasive ductal breast carcinoma with sizes > 10 mm
Aspect ratio, virtual touch tissue imaging grade, shear wave velocity, pathological invasive tumor size and histological grade are independently associated with axillary lymph node metastasis in invasive ductal breast carcinoma with sizes > 10 mm

Summary

Introduction

The nodal status of patients with breast cancer at initial clinical diagnosis is generally considered one of the most important factors for prognosis [2, 3]. If no metastatic axillary lymph nodes are detected, the standard procedure is sentinel lymph node biopsy (SLNB), but if the finding is positive, the patient has to undergo a second surgical procedure for axillary lymph node dissection (ALND) [7]. SLNB has been incorporated into www.impactjournals.com/oncotarget standard guidelines as an appropriate initial alternative to ALND in patients with clinically node-negative breast cancer [11]. Accurate prediction of axillary nodal status using a noninvasive imaging technique at this juncture would be of great value in such patients to avoid unnecessary axillary surgery, including SLNB. To evaluate whether conventional ultrasound, elastography [conventional strain elastography of elasticity imaging, acoustic radiation force impulse induced strain elastography of virtual touch tissue imaging, and a novel twodimensional shear wave elastography of virtual touch tissue imaging quantification] and clinicopathological factors are associated with axillary lymph node metastasis in invasive ductal breast carcinoma with sizes > 10 mm

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