Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.
Clin Imaging. 2023 Sep;101:190-199. doi: 10.1016/j.clinimag.2023.06.006. Epub 2023 Jun 9.
To examine correlations between shear-wave elastography (SWE) parameters with molecular subtype and axillary lymph node (LN) status of breast cancer.
We retrospectively analyzed 545 consecutive women (mean age, 52.7 ± 10.7 years; range, 26-83) with breast cancer who underwent preoperative breast ultrasound with SWE between December 2019 and January 2021. SWE parameters (E, E, and E) and the histopathologic information from surgical specimens including histologic type, histologic grade, size of invasive cancer, hormone receptor and HER2 status, Ki-67 proliferation index, and axillary LN status were analyzed. The relationships between SWE parameters and histopathologic findings were analyzed using an independent sample t-test, one-way ANOVA test with Tukey's post hoc test, and logistic regression analyses.
Higher stiffness values of SWE were associated with larger lesion size (>20 mm) on ultrasound, high histologic grade, larger invasive cancer size (>20 mm), high Ki-67, and axillary LN metastasis. E and E were the lowest in the luminal A-like subtype, and all three parameters were the highest in the triple-negative subtype. Lower value of E was independently associated with the luminal A-like subtype (P = 0.04). Higher value of E was independently associated with axillary LN metastasis for tumors ≤ 20 mm (P = 0.03).
Increases in the tumor stiffness values on SWE were significantly associated with aggressive histopathologic features of breast cancer. Lower stiffness values were associated with the luminal A-like subtype, and tumors with higher stiffness values were associated with axillary LN metastasis in small breast cancers.
探讨剪切波弹性成像（SWE）参数与乳腺癌分子亚型和腋窝淋巴结（LN）状态的相关性。
我们回顾性分析了 2019 年 12 月至 2021 年 1 月期间 545 例连续接受术前乳腺超声联合 SWE 检查的乳腺癌女性患者（平均年龄 52.7±10.7 岁；范围 26-83 岁）。分析 SWE 参数（E、E 和 E）以及手术标本的组织病理学信息，包括组织学类型、组织学分级、浸润性癌大小、激素受体和 HER2 状态、Ki-67 增殖指数和腋窝 LN 状态。采用独立样本 t 检验、单因素方差分析（Tukey 事后检验）和逻辑回归分析，研究 SWE 参数与组织病理学发现之间的关系。
SWE 较高的硬度值与超声上较大的病变大小（>20mm）、高组织学分级、较大的浸润性癌大小（>20mm）、高 Ki-67 和腋窝 LN 转移相关。E 和 E 在管腔 A 样亚型中最低，所有三种参数在三阴性亚型中最高。E 值越低，与管腔 A 样亚型独立相关（P=0.04）。E 值越高，与肿瘤直径≤20mm 的腋窝 LN 转移独立相关（P=0.03）。
SWE 上肿瘤硬度值的增加与乳腺癌侵袭性组织病理学特征显著相关。较低的硬度值与管腔 A 样亚型相关，而具有较高硬度值的肿瘤与小乳腺癌中的腋窝 LN 转移相关。
