Department of Breast Imaging and Intervention, Shizuoka Cancer Center Hospital, Nagaizumi, Shizuoka, Japan.
Department of Breast Surgery, Shizuoka Cancer Center Hospital, Nagaizumi, Japan.
Breast Cancer. 2019 Mar;26(2):206-214. doi: 10.1007/s12282-018-0914-0. Epub 2018 Sep 26.
Breast cancer growth is generally expected to differ between tumor subtypes. We aimed to evaluate tumor doubling time (DT) using ultrasonography and verify whether each tumor subtype has a unique DT.
This retrospective study included 265 patients with invasive breast cancer who received serial ultrasonography between diagnosis and surgery. Tumor diameters were measured in three directions and DTs were calculated according to an exponential growth model using the volume change during serial ultrasonography. We investigated the relationships between DT, tumor subtype, and histopathological factors.
Volumes did not change in 95 (36%) of 265 tumors and increased in 170 (64%) tumors during serial ultrasonography (mean interval, 56.9 days). The mean volume increases of all tumors and volume-increased tumors were 22.1% and 34.5%, respectively. Triple-negative tumors had greater volume increases (40% vs. 20%, p = 0.001) and shorter DT (124 vs. 185 days, p = 0.027) than estrogen receptor (ER)+/human epidermal growth factor receptor 2 (HER2)- tumors. Volume-increased tumors had higher Ki-67 indices than those of volume-stable tumors in ER+/HER2- (p = 0.002) and ER+/HER2+ tumors (p = 0.011) and higher histological grades in all tumors except triple-negative tumors (p < 0.001). Triple-negative tumors with DTs < 90 days (short-DT) showed higher Ki-67 indices than those with DTs > 90 days (long-DT) (p = 0.008). In ER+/HER2- tumors, histological grades were higher for short-DT than for long-DT tumors (p = 0.022).
Differences in tumor DT depending on breast cancer subtype, Ki-67 index, and histological grade were confirmed using serial ultrasonography even during preoperative short interval.
乳腺癌的生长通常预计在肿瘤亚型之间有所不同。我们旨在使用超声评估肿瘤倍增时间（DT），并验证每种肿瘤亚型是否具有独特的 DT。
本回顾性研究纳入了 265 名接受诊断与手术之间连续超声检查的浸润性乳腺癌患者。在三个方向上测量肿瘤直径，并根据体积变化使用超声检查中使用的指数增长模型计算 DT。我们研究了 DT、肿瘤亚型和组织病理学因素之间的关系。
在 265 个肿瘤中，有 95 个（36%）肿瘤的体积没有变化，而在 170 个肿瘤（64%）中体积增加。所有肿瘤和体积增加的肿瘤的平均体积增加分别为 22.1%和 34.5%。三阴性肿瘤的体积增加更大（40%比 20%，p=0.001），DT 更短（124 天比 185 天，p=0.027），比雌激素受体（ER）+/人表皮生长因子受体 2（HER2）-肿瘤。与体积稳定的肿瘤相比，体积增加的肿瘤在 ER+/HER2-（p=0.002）和 ER+/HER2+（p=0.011）肿瘤中 Ki-67 指数更高，除三阴性肿瘤外，所有肿瘤的组织学分级更高（p<0.001）。DT<90 天（短-DT）的三阴性肿瘤的 Ki-67 指数高于 DT>90 天（长-DT）的肿瘤（p=0.008）。在 ER+/HER2-肿瘤中，短-DT 肿瘤的组织学分级高于长-DT 肿瘤（p=0.022）。
使用连续超声检查，即使在术前短时间内，也可以确认肿瘤 DT 取决于乳腺癌亚型、Ki-67 指数和组织学分级的差异。
