A Prospective Two Center Study Comparing Breast Cancer Lesion Size Defined by 2D Shear Wave Elastography, B-Mode Ultrasound, and Mammography with the Histopathological Size

Abstract Purpose The aim of the present study was to determine the accuracy of breast cancer measurement with 2 D shear wave elastography (2 D SWE), B-mode ultrasound, and mammography by comparing these methods with the actual histopathological tumor size. Materials and Methods 135 patients with proven malignant breast lesions at two centers were included in a prospective study. The maximum lesion diameter was measured by 2 D SWE, B-mode ultrasound, and mammography. After surgery, the histopathological tumor size was measured by a pathologist. Results The mean difference in tumor size on 2 D SWE, B-mode ultrasound, and mammography on the one hand, and the actual tumor size on the other, was –0.03 cm, 0.16 cm and 0.10 cm, respectively. Lesion size on histopathological investigation was overestimated by 2 D SWE (p = 0.004) and underestimated by B-mode imaging (p < 0.001). All three imaging methods underestimated the size of invasive lobular cancers and lesions > 15 mm; 2 D SWE was most accurate in this regard. Conclusion 2 D SWE predicted lesion size more precisely than B-mode ultrasound or mammography. In cases of invasive lobular carcinoma, all three imaging methods underestimated lesion size, with 2 D SWE coming closest to the actual tumor size.

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Accuracy of tumor size measurement: comparison of B-mode ultrasound, strain elastography, and 2D and 3D shear wave elastography with histopathological lesion size

Acta Radiologica ◽

10.1177/0284185118787354 ◽

2018 ◽

Vol 60 (4) ◽

pp. 451-458 ◽

Cited By ~ 2

Author(s):

André Farrokh ◽

Nicolai Maass ◽

Linn Treu ◽

Thorsten Heilmann ◽

Fritz KW Schäfer

Keyword(s):

Shear Wave ◽

Tumor Size ◽

Lobular Carcinoma ◽

Treatment Strategies ◽

Shear Wave Elastography ◽

Lesion Size ◽

Size Measurement ◽

Strain Elastography ◽

2D And 3D ◽

Histopathological Lesion

Background Predicting the exact extent of a breast tumor is of great importance for oncologic treatment strategies. Different types of elastography can be used as new tools for measuring lesion size. Purpose To provide evidence regarding the accuracy of tumor size measurement of strain elastography (SE), two-dimensional (2D) and three-dimensional (3D) shear wave elastography (SWE), and conventional B-image ultrasound. Material and Methods In this prospective study, the diameter of 105 malignant breast lesions was measured by SE, 2D and 3D SWE, and B-mode ultrasound. The histopathological lesion size was compared to all imaging-based measuring methods. Results The mean lesion size of all breast carcinomas was 1.54 cm. B-mode ultrasound underestimates breast cancer size in 65.7 % of all cases in this study ( P < 0.0001). Mean lesion size was more accurately determined by SE, 2D and 3D SWE compared to B-mode ultrasound. Absolute differences between measured and actual lesion are smaller for B-mode ultrasound (0.26 cm) than for SE (0.41 cm) and 2D and 3D SWE (0.41 cm and 0.44 cm, respectively). Conclusion B-mode ultrasound allows more accurate lesion size measurement than SE and 2D or 3D SWE but has a significantly higher risk of underestimating tumor size which could lead to incomplete margins during surgery. 3D SWE was not superior to 2D SWE or SE but by trend more precise in predicting the size of invasive lobular carcinoma.

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Elastic Modulus and Elasticity Ratio of Malignant Breast Lesions with Shear Wave Ultrasound Elastography: Variations with Different Region of Interest and Lesion Size

Diagnostics ◽

10.3390/diagnostics11061015 ◽

2021 ◽

Vol 11 (6) ◽

pp. 1015

Author(s):

Antonio Bulum ◽

Gordana Ivanac ◽

Eugen Divjak ◽

Iva Biondić Špoljar ◽

Martina Džoić Dominković ◽

...

Keyword(s):

Elastic Modulus ◽

Shear Wave ◽

Large Diameter ◽

Small Diameter ◽

Shear Wave Elastography ◽

Lesion Size ◽

Ultrasound Elastography ◽

Breast Lesions ◽

Malignant Breast ◽

The Impact

Shear wave elastography (SWE) is a type of ultrasound elastography with which the elastic properties of breast tissues can be quantitatively assessed. The purpose of this study was to determine the impact of different regions of interest (ROI) and lesion size on the performance of SWE in differentiating malignant breast lesions. The study included 150 female patients with histopathologically confirmed malignant breast lesions. Minimal (Emin), mean (Emean), maximal (Emax) elastic modulus and elasticity ratio (e-ratio) values were measured using a circular ROI size of 2, 4 and 6 mm diameters and the lesions were divided into large (diameter ≥ 15 mm) and small (diameter < 15 mm). Highest Emin, Emean and e-ratio values and lowest variability were observed when using the 2 mm ROI. Emax values did not differ between different ROI sizes. Larger lesions had significantly higher Emean and Emax values, but there was no difference in e-ratio values between lesions of different sizes. In conclusion, when measuring the Emin, Emean and e-ratio of malignant breast lesions using SWE the smallest possible ROI size should be used regardless of lesion size. ROI size has no impact on Emax values while lesion size has no impact on e-ratio values.

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Power Doppler Ultrasonography and Shear Wave Elastography as Complementary Imaging Methods for Suspected Local Breast Cancer Recurrence

Journal of Ultrasound in Medicine ◽

10.1002/jum.14493 ◽

2017 ◽

Vol 37 (6) ◽

pp. 1493-1501 ◽

Cited By ~ 1

Author(s):

Rodrigo Menezes Jales ◽

Maira Teixeira Dória ◽

Kátia Piton Serra ◽

Mila Meneguelli Miranda ◽

Carlos Alberto Menossi ◽

...

Keyword(s):

Breast Cancer ◽

Shear Wave ◽

Doppler Ultrasonography ◽

Power Doppler ◽

Cancer Recurrence ◽

Shear Wave Elastography ◽

Breast Cancer Recurrence ◽

Power Doppler Ultrasonography ◽

Imaging Methods

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IGF-1 and IGF-2 serum concentrations in patients with benign and malignant breast cancer: Free IGF-2 is correlated with breast tumor size

European Journal of Cancer ◽

10.1016/s0959-8049(02)80145-9 ◽

2002 ◽

Vol 38 (11) ◽

pp. S54

Author(s):

C Singer

Keyword(s):

Breast Cancer ◽

Tumor Size ◽

Breast Tumor ◽

Serum Concentrations ◽

Malignant Breast

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Decreased Size of Mammary Tumors Caused by Preoperative Treatment with Aglepristone in Female Domestic Dogs (Canis familiaris) Do Not Influence the Density of the Benign Neoplastic Tissue Measured Using Shear Wave Elastography Technique

Animals ◽

10.3390/ani11020527 ◽

2021 ◽

Vol 11 (2) ◽

pp. 527 ◽

Cited By ~ 1

Author(s):

Barbara Pieczewska ◽

Kamila Glińska-Suchocka ◽

Wojciech Niżański ◽

Michał Dzięcioł

Keyword(s):

Shear Wave ◽

Tumor Size ◽

Histopathological Examination ◽

Shear Wave Elastography ◽

Mammary Tumors ◽

Needle Aspiration ◽

Surgical Removal ◽

Preoperative Treatment ◽

Neoplastic Tissue ◽

Before And After

Shear wave elastography (SWE) can be useful to discriminate between malignant and benign mammary tumors. In dogs with elevated progesterone levels compared to the baseline and fast-growing tumors, treatment with the use of aglepristone allows for tumor size reduction, which facilitates surgery. This study aimed to evaluate the influence of the preoperative treatment of benign mammary tumors (BMTs), performed with the use of aglepristone, on the density of the tumor tissue measured by SWE. Twelve female dogs with diagnosed BMTs and increased levels of progesterone were treated with aglepristone (Alizine, Virbac, France) at 10 mg/kg s.c. (Subcutaneous injection). twice, with a 24 h interval. The density of the tumor was evaluated by SWE before and after the treatment. The type of tumor was evaluated by fine needle aspiration cytology before treatment, and a histopathological examination was made after surgical removal, performed after the aglepristone treatment. In all the cases, a significant reduction in the mammary tumor’s size was observed following treatment, with no influence on the density of the tumor’s tissue measured by SWE. Similar studies on malignant mammary tumors are warranted to verify if in these cases, density will also be a constant parameter that is not dependent on the tumor size.

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Early assessment of shear wave elastography parameters foresees the response to neoadjuvant chemotherapy in patients with invasive breast cancer

Breast Cancer Research ◽

10.1186/s13058-021-01429-4 ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Juanjuan Gu ◽

Eric C. Polley ◽

Max Denis ◽

Jodi M. Carter ◽

Sandhya Pruthi ◽

...

Keyword(s):

Breast Cancer ◽

Neoadjuvant Chemotherapy ◽

Shear Wave ◽

Invasive Breast Cancer ◽

Shear Wave Elastography ◽

Early Prediction ◽

Early Assessment ◽

Significant Difference ◽

Mass Size ◽

Response To Neoadjuvant Chemotherapy

Abstract Background Early prediction of tumor response to neoadjuvant chemotherapy (NACT) is crucial for optimal treatment and improved outcome in breast cancer patients. The purpose of this study is to investigate the role of shear wave elastography (SWE) for early assessment of response to NACT in patients with invasive breast cancer. Methods In a prospective study, 62 patients with biopsy-proven invasive breast cancer were enrolled. Three SWE studies were conducted on each patient: before, at mid-course, and after NACT but before surgery. A new parameter, mass characteristic frequency (fmass), along with SWE measurements and mass size was obtained from each SWE study visit. The clinical biomarkers were acquired from the pre-NACT core-needle biopsy. The efficacy of different models, generated with the leave-one-out cross-validation, in predicting response to NACT was shown by the area under the receiver operating characteristic curve and the corresponding sensitivity and specificity. Results A significant difference was found for SWE parameters measured before, at mid-course, and after NACT between the responders and non-responders. The combination of Emean2 and mass size (s2) gave an AUC of 0.75 (0.95 CI 0.62–0.88). For the ER+ tumors, the combination of Emean_ratio1, s1, and Ki-67 index gave an improved AUC of 0.84 (0.95 CI 0.65–0.96). For responders, fmass was significantly higher during the third visit. Conclusions Our study findings highlight the value of SWE estimation in the mid-course of NACT for the early prediction of treatment response. For ER+ tumors, the addition of Ki-67improves the predictive power of SWE. Moreover, fmass is presented as a new marker in predicting the endpoint of NACT in responders.

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Application of 3D and 2D quantitative shear wave elastography (SWE) to differentiate between benign and malignant breast masses

Scientific Reports ◽

10.1038/srep41216 ◽

2017 ◽

Vol 7 (1) ◽

Cited By ~ 7

Author(s):

Jie Tian ◽

Qianqi Liu ◽

Xi Wang ◽

Ping Xing ◽

Zhuowen Yang ◽

...

Keyword(s):

Shear Wave ◽

Shear Wave Elastography ◽

Breast Masses ◽

Malignant Breast

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Combination of shear wave elastography and BI-RADS in identification of solid breast masses

BMC Medical Imaging ◽

10.1186/s12880-021-00702-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xue Zheng ◽

Fei Li ◽

Zhi-Dong Xuan ◽

Yu Wang ◽

Lei Zhang

Keyword(s):

Shear Wave ◽

Breast Imaging ◽

Color Doppler ◽

Shear Wave Elastography ◽

Definitive Diagnosis ◽

Pathological Examination ◽

Diagnostic Specificity ◽

Breast Masses ◽

Malignant Breast ◽

Grade Ii

Abstract Background To explore the value of quantitative shear wave elastography (SWE) plus the Breast Imaging Reporting and Data System (BI-RADS) in the identification of solid breast masses. Methods A total of 108 patients with 120 solid breast masses admitted to our hospital from January 2019 to January 2020 were enrolled in this study. The pathological examination served as the gold standard for definitive diagnosis. Both SWE and BI-RADS grading were performed. Results Out of the 120 solid breast masses in 108 patients, 75 benign and 45 malignant masses were pathologically confirmed. The size, shape, margin, internal echo, microcalcification, lateral acoustic shadow, and posterior acoustic enhancement of benign and malignant masses were significantly different (all P < 0.05). The E mean, E max, SD, and E ratio of benign and malignant masses were significantly different (all P < 0.05). The E min was similar between benign and malignant masses (P > 0.05). The percentage of Adler grade II-III of the benign masses was lower than that of the malignant masses (P < 0.05). BI-RADS plus SWE yielded higher diagnostic specificity and positive predictive value than either BI-RADS or SWE; BI-RADS plus SWE yielded the highest diagnostic accuracy among the three methods (all P < 0.05). Conclusion SWE plus routine ultrasonography BI-RADS has a higher value in differentiating benign from malignant breast masses than color doppler or SWE alone, which should be further promoted in clinical practice.

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Multiparametric ultrasound diagnosis of metastatic and lymphoproliferative changes in lymph nodes in primary-multiple malignant tumors, including breast cancer and lymphoma

Malignant tumours ◽

10.18027/2224-5057-2018-8-4-37-44 ◽

2019 ◽

Vol 8 (4) ◽

pp. 37-44 ◽

Cited By ~ 3

Author(s):

E. V. Kovaleva ◽

T. Yu. Danzanova ◽

G. T. Sinyukova ◽

P. I. Lepedatu ◽

E. A. Gudilina ◽

...

Keyword(s):

Breast Cancer ◽

Differential Diagnosis ◽

Lymph Nodes ◽

Shear Wave ◽

Malignant Tumors ◽

Shear Wave Elastography ◽

Doppler Imaging ◽

Contrast Enhanced Ultrasound ◽

Contrast Enhanced ◽

Multiparametric Ultrasound

In this article, based on two clinical examples, the possibilities of multiparametric ultrasound in the differential diagnosis of metastatic and lymphoproliferative changes in lymph nodes in primary-multiple malignant tumors, including breast cancer and lym - phoma, are evaluated. Multiparameteric ultrasound includes B-mode, color and energy Doppler imaging, strain elastography, shear wave elastography and contrast-enhanced ultrasound (CEUS). Standardization and reproducibility of these ultrasound techniques will allow to objectify the study, obtaining specific indicators of shear wave velocity in the zones of interest and specific signs of contrast enhancement, which can be used as impor tant differential diagnostic tool in oncology.

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