Pre-operative Conventional Ultrasound and Sonoelastography Evaluation for Predicting Axillary Lymph Node Metastasis in Patients with Malignant Breast Lesions

Ultrasound Med Biol. 2018 Dec;44(12):2587-2595. doi: 10.1016/j.ultrasmedbio.2018.07.017. Epub 2018 Aug 31.

Abstract

The objective of our study was to evaluate the association between the sonoelastography features of breast tumor and axillary lymph node metastasis (ALNM) in patients with breast cancer. In a cohort of 106 women with breast cancer, the conventional ultrasound features and elasticity parameters by elasticity imaging and Virtual Touch Tissue Imaging & Quantification (VTIQ) were retrospectively analyzed. Ultrasound and elastography findings were compared with pathologic axillary lymph node status. Receiver operating characteristic curve analysis was used to evaluate diagnostic performance. Pathologically, the overall incidence of ALNM was 39.6% (42/106) in the final analysis. ALNM was significantly more frequent in tumors with elasticity imaging scores >4.5, maximal shear wave velocity values (Smax) >6.42 m/s and mean shear wave velocity values (Smean) >5.66 m/s, respectively. The sensitivity, specificity and accuracy were 78.6%, 54.7% and 64.2% for elasticity imaging score; 85.7%, 54.7% and 67.0% for Smax; and 59.5%, 79.7% and 71.7% for Smean, respectively Elastography features, including elasticity imaging score and VTIQ, can be used to supplement conventional ultrasound to predict ALNM in patients with breast cancers.

Keywords: Axillary lymph node metastasis; Breast cancer; Shear wave elastography; Strain elastography; Ultrasound.

MeSH terms

  • Adult
  • Aged
  • Axilla
  • Breast Neoplasms / pathology*
  • Diagnosis, Differential
  • Elasticity Imaging Techniques / methods*
  • Female
  • Humans
  • Lymph Nodes / diagnostic imaging*
  • Lymphatic Metastasis / diagnostic imaging*
  • Middle Aged
  • Preoperative Care / methods*
  • Reproducibility of Results
  • Retrospective Studies
  • Sensitivity and Specificity
  • Ultrasonography / methods