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European Radiology

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02-04-2022 | Ultrasound | Breast

Combining conventional ultrasound and sonoelastography to predict axillary status after neoadjuvant chemotherapy for breast cancer

Authors: Jia-Xin Huang, Shi-Yang Lin, Yan Ou, Cai-Gou Shi, Yuan Zhong, Ming-Jie Wei, Xiao-Qing Pei

Published in: European Radiology | Issue 9/2022

Abstract

Objective

To determine the ability of conventional ultrasound (US) combined with shear wave elastography (SWE) to reveal axillary status after neoadjuvant chemotherapy (NAC) in breast cancer patients.

Methods

From September 2016 to December 2021, 201 patients with node-positive breast cancer who underwent NAC were enrolled in this prospective study. Conventional US features of axillary lymph nodes and SWE characteristics of breast lesions after NAC were analyzed. The diagnostic performances of US, SWE, and their combination were assessed using multivariate logistic regression and receiver operator characteristic curve (ROC) analyses.

Results

The area under the ROC curve (AUC) for the ability of conventional US features to determine axillary status after NAC was 0.82, with a sensitivity of 85.23%, a specificity of 67.39%, and an accuracy of 76.11%. Shear wave velocity (SWV) displayed moderate performance for predicting axilla status after NAC with SWV_mean demonstrating an AUC of 0.85. Cortical thickness and shape of axillary nodes and SWV_mean of breast tumors were independently associated with axillary nodal metastasis after NAC. Compared to conventional US, the combination of conventional US of axillary lymph nodes with SWE of breast lesions achieved a significantly higher AUC (0.90 vs 0.82, p < 0.01, Delong’s test) with a sensitivity of 87.50%, improved specificity of 82.61% and accuracy of 85.00%.

Conclusions

Breast SWE was independently associated with residual metastasis of axillary node after NAC in patients with initially diagnosed positive axilla. Combining SWE with conventional US showed good diagnostic performance for axillary node disease after NAC.

Key Points

• Breast SWE can serve as a supplement to axilla US for the evaluation of the axilla after NAC.

• The combination of axilla US with breast SWE may be a promising method to facilitate less-invasive treatment in patients receiving NAC.

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Title: Combining conventional ultrasound and sonoelastography to predict axillary status after neoadjuvant chemotherapy for breast cancer
Authors: Jia-Xin Huang
Shi-Yang Lin
Yan Ou
Cai-Gou Shi
Yuan Zhong
Ming-Jie Wei
Xiao-Qing Pei
Publication date: 02-04-2022
Publisher: Springer Berlin Heidelberg
Keywords: Ultrasound
Metastasis
Breast Cancer
Breast Cancer
Ultrasound
Cytostatic Therapy
Published in: European Radiology / Issue 9/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-022-08751-1

At a glance: The STEP trials

Springer Medicine

Combining conventional ultrasound and sonoelastography to predict axillary status after neoadjuvant chemotherapy for breast cancer

Abstract

Objective

Methods

Results

Conclusions

Key Points

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Key Points

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