Jia-Xin Huang1, Shi-Yang Lin2, Yan Ou3, Cai-Gou Shi4, Yuan Zhong1, Ming-Jie Wei1, Xiao-Qing Pei5. 1. Department of Medical Ultrasound, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No. 651 Dongfeng Road East, Guangzhou, 510000, China. 2. Department of Medical Ultrasound, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510000, China. 3. Department of Medical Ultrasound, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, 518000, China. 4. Department of Medical Ultrasound, Liuzhou People's Hospital, Liuzhou, 545000, China. 5. Department of Medical Ultrasound, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No. 651 Dongfeng Road East, Guangzhou, 510000, China. peixq@sysucc.org.cn.
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 SWVmean demonstrating an AUC of 0.85. Cortical thickness and shape of axillary nodes and SWVmean 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.
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 SWVmean demonstrating an AUC of 0.85. Cortical thickness and shape of axillary nodes and SWVmean 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.
Authors: Judy C Boughey; Karla V Ballman; Kelly K Hunt; Linda M McCall; Elizabeth A Mittendorf; Gretchen M Ahrendt; Lee G Wilke; Huong T Le-Petross Journal: J Clin Oncol Date: 2015-02-02 Impact factor: 44.544
Authors: Viviana Galimberti; Bernard F Cole; Giuseppe Viale; Paolo Veronesi; Elisa Vicini; Mattia Intra; Giovanni Mazzarol; Samuele Massarut; Janez Zgajnar; Mario Taffurelli; David Littlejohn; Michael Knauer; Carlo Tondini; Angelo Di Leo; Marco Colleoni; Meredith M Regan; Alan S Coates; Richard D Gelber; Aron Goldhirsch Journal: Lancet Oncol Date: 2018-09-05 Impact factor: 41.316
Authors: William J Gradishar; Benjamin O Anderson; Jame Abraham; Rebecca Aft; Doreen Agnese; Kimberly H Allison; Sarah L Blair; Harold J Burstein; Chau Dang; Anthony D Elias; Sharon H Giordano; Matthew P Goetz; Lori J Goldstein; Steven J Isakoff; Jairam Krishnamurthy; Janice Lyons; P Kelly Marcom; Jennifer Matro; Ingrid A Mayer; Meena S Moran; Joanne Mortimer; Ruth M O'Regan; Sameer A Patel; Lori J Pierce; Hope S Rugo; Amy Sitapati; Karen Lisa Smith; Mary Lou Smith; Hatem Soliman; Erica M Stringer-Reasor; Melinda L Telli; John H Ward; Jessica S Young; Jennifer L Burns; Rashmi Kumar Journal: J Natl Compr Canc Netw Date: 2020-04 Impact factor: 11.908
Authors: Judy C Boughey; Vera J Suman; Elizabeth A Mittendorf; Gretchen M Ahrendt; Lee G Wilke; Bret Taback; A Marilyn Leitch; Henry M Kuerer; Monet Bowling; Teresa S Flippo-Morton; David R Byrd; David W Ollila; Thomas B Julian; Sarah A McLaughlin; Linda McCall; W Fraser Symmans; Huong T Le-Petross; Bruce G Haffty; Thomas A Buchholz; Heidi Nelson; Kelly K Hunt Journal: JAMA Date: 2013-10-09 Impact factor: 56.272