Ninewells Hospital and Medical School, James Arrott Drive, Dundee, DD2 9SY, UK.
Ninewells Hospital and Medical School, James Arrott Drive, Dundee, DD2 9SY, UK.
Clin Radiol. 2020 Nov;75(11):879.e13-879.e21. doi: 10.1016/j.crad.2020.07.012. Epub 2020 Aug 14.
To assess whether ultrasound features of breast cancer are associated with breast cancer specific survival (BCSS).
Within a single breast service, data was collected prospectively (April 2010-April 2012) from 319 consecutive women (mean age 63 years) with 335 ultrasound-visible invasive breast cancers. Ultrasound features were evaluated retrospectively from the recorded images according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon by a radiologist blinded to outcomes. Survival and cause of death were ascertained from local and national sources. Kaplan-Meier survival curves were generated, and statistical significance tested using the log-rank test.
Mean follow-up in those alive was 80.9 months. Thirty breast cancer deaths and 45 non-breast cancer deaths occurred. Five-year BCSS in the presence of distal acoustic enhancement was 76% compared to 88%, 96%, and 100% for those with distal shadowing, no distal effect or combined effect respectively (p<0.0002). Patients with sonographic skin involvement had 73% 5-year BCSS compared to 92% for no skin involvement (p<0.0001). Focal oedema was associated with 56% 5-year BCSS compared to 89% for those without (p=0.0002). A significant association was demonstrated between ultrasound tumour size and BCSS (p<0.0001). At multivariate analysis, skin changes, distal enhancement, and focal oedema maintained prognostic significance.
Distal enhancement, focal oedema, and skin involvement have strong associations with breast cancer death. These factors could be taken into account, along with lesion size and other commonly used preoperative prognostic features, when considering management of women with breast cancer.
评估乳腺癌的超声特征是否与乳腺癌特定生存（BCSS）相关。
在单一的乳腺服务中，数据是前瞻性收集的（2010 年 4 月至 2012 年 4 月），来自 319 名连续的（平均年龄 63 岁）患有 335 例超声可见浸润性乳腺癌的女性。超声特征是由一名对结果不知情的放射科医生根据乳腺成像报告和数据系统（BI-RADS）词汇从记录的图像中进行回顾性评估的。生存和死因是从当地和国家来源确定的。使用对数秩检验生成 Kaplan-Meier 生存曲线，并检验其统计学意义。
存活者的平均随访时间为 80.9 个月。发生 30 例乳腺癌死亡和 45 例非乳腺癌死亡。在存在远端声学增强的情况下，5 年 BCSS 为 76%，而存在远端阴影、无远端效应或联合效应的患者分别为 88%、96%和 100%（p<0.0002）。有超声皮肤受累的患者 5 年 BCSS 为 73%，而无皮肤受累的患者为 92%（p<0.0001）。局灶性水肿与 5 年 BCSS 相关，为 56%，而无局灶性水肿的患者为 89%（p=0.0002）。超声肿瘤大小与 BCSS 之间存在显著关联（p<0.0001）。在多变量分析中，皮肤改变、远端增强和局灶性水肿保持预后意义。
远端增强、局灶性水肿和皮肤受累与乳腺癌死亡有很强的关联。在考虑乳腺癌妇女的管理时，可以考虑这些因素，以及病变大小和其他常用的术前预后特征。
