Shao Sihui, Yao Minghua, Li Chunxiao, Li Xin, Wang Jianfeng, Chen Jing, Zheng Yi, Wu Rong
Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of General Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Oncol. 2023 Mar 16;13:1103397. doi: 10.3389/fonc.2023.1103397. eCollection 2023.
Some women die despite the favorable prognosis of small breast cancers. Breast ultrasound features may reflect pathological and biological characteristics of a breast tumor. This study aimed to explore whether ultrasound features could identify small breast cancers with poor outcomes.
This retrospective study examined confirmed breast cancers with a size of <20 mm diagnosed in our hospital between 02/2008 and 08/2019. Clinicopathological and ultrasound features were compared between alive and deceased breast cancer patients. Survival was analyzed using the Kaplan-Meier curves. Multivariable Cox proportional hazards models were used to examine the factors associated with breast cancer-specific survival (BCSS) and disease-free survival (DFS).
Among the 790 patients, the median follow-up was 3.5 years. The deceased group showed higher frequencies of spiculated (36.7% vs. 11.2%, P<0.001), anti-parallel orientation (43.3% vs. 15.4%, P<0.001), and spiculated morphology combined with anti-parallel orientation (30.0% vs. 2.4%, P<0.001). Among 27 patients with spiculated morphology and anti-parallel orientation, nine cancer-specific deaths and 11 recurrences occurred, for a 5-year BCSS of 77.8% and DFS of 66.7%, while 21 breast-cancer deaths and 41 recurrences occurred among the remaining patients with higher 5-year BCSS (97.8%, P<0.001) and DFS (95.4%, P<0.001). Spiculated and anti-parallel orientation (HR=7.45, 95%CI: 3.26-17.00; HR=6.42, 95%CI: 3.19-12.93), age ≥55 years (HR=5.94, 95%CI: 2.24-15.72; HR=1.98, 95%CI: 1.11-3.54), and lymph nodes metastasis (HR=3.99, 95%CI: 1.89-8.43; HR=2.99, 95%CI: 1.71-5.23) were independently associated with poor BCSS and DFS.
Spiculated and anti-parallel orientation at ultrasound are associated with poor BCSS and DFS in patients with primary breast cancer <20 mm.
尽管小乳腺癌预后良好，但仍有一些女性死亡。乳腺超声特征可能反映乳腺肿瘤的病理和生物学特征。本研究旨在探讨超声特征是否能识别出预后不良的小乳腺癌。
这项回顾性研究检查了2008年2月至2019年8月期间在我院确诊的大小<20mm的乳腺癌。比较了存活和死亡乳腺癌患者的临床病理和超声特征。采用Kaplan-Meier曲线分析生存率。使用多变量Cox比例风险模型检查与乳腺癌特异性生存（BCSS）和无病生存（DFS）相关的因素。
790例患者中，中位随访时间为3.5年。死亡组中毛刺状（36.7%对11.2%，P<0.001）、反平行方向（43.3%对15.4%，P<0.001）以及毛刺状形态合并反平行方向（30.0%对2.4%，P<0.001）的出现频率更高。在27例具有毛刺状形态和反平行方向的患者中，发生了9例癌症特异性死亡和11例复发，5年BCSS为77.8%，DFS为6
