Quantitative analysis of shear wave elastic heterogeneity for prediction of lymphovascular invasion in breast cancer

2021 ◽  
pp. 20210682
Author(s):  
Yini Huang ◽  
Yubo Liu ◽  
Yun Wang ◽  
Xueyi Zheng ◽  
Jing Han ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Negative Predictive Value ◽  
Shear Wave ◽  
Predictive Value ◽  
Lymphovascular Invasion ◽  
Imaging Biomarker ◽  
Lymph Node Status ◽  
Axillary Lymph ◽  
Breast Cancers ◽  
Ki 67

Objective: To evaluate the correlation between elastic heterogeneity (EH) and lymphovascular invasion (LVI) in breast cancers and assess the clinical value of using EH to predict LVI pre-operatively. Methods: This retrospective study consisted of 376 patients with breast cancers that had undergone shear wave elastography (SWE) with virtual touch tissue imaging quantification between June 2017 and June 2018. The EH was determined as the difference between the averaged three highest and three lowest shear wave value. Clinicalpathological parameters including histological type and grades, LVI, axillary lymph node status and molecular markers (estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2 and Ki-67) were reviewed and recorded. Relationship EH and clinicalpathological parameters was investigated respectively. The diagnostic performance of EH in distinguishing LVI or not was analyzed. Results: At multivariate regression analysis, only EH (p = 0.017) was positively correlated with LVI in all tumors. EH (p = 0.003) and Ki-67 (p = 0.025) were positively correlated with LVI in tumors ≤ 2 cm. None of clinicalpathological parameters were correlated with LVI in tumors > 2 cm (p > 0.05 for all). Using EH to predict LVI in tumors ≤ 2 cm, the sensitivity and negative predictive value were 93 and 89% respectively. Conclusion: EH has the potential to be served as an imaging biomarker to predict LVI in breast cancer especially for tumors ≤ 2 cm. Advances in knowledge: There was no association between LVI and other most commonly used elastic features such as SWVmean and SWVmax. Elastic heterogeneity is an independent predictor of LVI, so it can provide additional prognostic information for routine preoperative breast cancer assessment. For tumors ≤ 2cm, using EH value higher than 1.36 m/s to predict LVI involvement, the sensitivity and negative predictive value can reach to 93% and 89%, respectively, suggesting that breast cancer with negative EH value was more likely to be absent of LVI.

scholarly journals Shear Wave Elastography-Assisted Ultrasound Breast Image Analysis and Identification of Abnormal Data

2022 ◽  
Vol 2022 ◽  
pp. 1-10
Author(s):  
Caoxin Yan ◽  
Zhiyan Luo ◽  
Zimei Lin ◽  
Huilin He ◽  
Yunkai Luo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Shear Wave ◽  
Shear Wave Elastography ◽  
Lymph Node Status ◽  
Axillary Lymph ◽  
Axillary Lymph Node Status ◽  
Ki 67 ◽  
Freeze Thaw ◽  
Quantitative Metrics ◽  
Her 2

In this paper, shear wave elastography was used to study and analyze the images of the breast in-depth and identify the abnormal image data. Sixty breast lesions were evaluated, and quantitative metrics were reproducible in the static and dynamic modes of shear wave elastography with a higher interobserver agreement in dynamic qualitative metrics than in the static mode. There were no statistically significant differences between the two modes of imaging in quantitative metrics, and quantitative metrics were more effective than qualitative metrics. Postoperative immunohistochemical expression of ER, PR, HER-2, Ki-67, molecular typing, pathological type, histological grading, and axillary lymph node status of breast cancer was obtained based on pathological results. The correlation between mass size, patient age, and WiMAX values of breast cancer masses was analyzed using Pearson correlation, and the differences in SWVmax values of breast cancer masses between different expressions of immunohistochemical parameters ER, PR, HER-2, Ki-67, and axillary lymph node status were compared using tests. The variables with correlations and differences were included in the multiple linear regression analysis to assess the factors influencing the SWVmax values. The performance of TDPM, SPM, and TSPM was compared using PVA body models with different freeze-thaw cycles. The results showed that TSPM performed better than SPM in general, and TDPM showed excellent performance because of high temporal resolution and low random error, especially when the number of freeze-thaw cycles increased and the hardness of the PVA body mold increased. Measurements at different depths of inhomogeneous body models also showed that the TDPM method was less affected by depth, and the results were more stable. Finally, the reliability of the shear wave velocity (SWS) measured by the TDPM and SPM methods was investigated using porcine ligament tissue, and the results showed that the mean values of SWS goodness of fit for TDPM and SPM were 0.94 and 0.87, respectively, and the estimated elastic modulus of TDPM was very close to the mechanical test results.

Preoperative conventional axillary ultrasound (AUS) and sonoelastography (SE) for predicting axillary lymph node metastasis in breast cancer patients.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e12074-e12074
Author(s):  
Alexander Petrovsky ◽  
Nafset Khakurinova ◽  
Vladimir Sholokhov ◽  
Ramiz Valiev ◽  
Sergey Berdnikov ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Positive Predictive Value ◽  
Lymph Nodes ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Axillary Lymph ◽  
Training Cohort ◽  
The Us ◽  
Negative Lymph Nodes ◽  
Positive Lymph Nodes

e12074 Background: Patients with operable breast cancer (BC) and clinically negative lymph nodes (CNLN) usually undergo sentinel lymph node biopsy (SNLB) or axillary lymph nodes dissection (ALND). AUS followed by fine-needle aspiration (FNA) or core-needle biopsy (CNB) could decrease number of unnecessary SNLBs and allow to assign patient to ALND directly. On the other hand, new AUS techniques such as SWE could enhance AUS specificity and allow to avoid SNLB in some patients. Aim: To assess sensitivity, specificity and negative predictive value of the AUS+SWE followed by FNA or CNB in patients with operable BC. Methods: Since Sep 2012 to Jan 2018 150 pts with operable BC and were enrolled. We include 30 pts in training cohort with clinically positive lymph nodes to verify AUS+SWE sensitivity and specificity. In validation cohort only those pts who were candidates for SNLB and who presented with tumor staging up to T3, and clinically negative axillae were included (n=120). All patients underwent preoperative AUS in B-mode, SWE, followed by FNA or CNB in case of suspicious nodes were detected. All pts underwent axilla surgery (SNLB = 46, ALND =74) and final pathology outcomes were available for all pts. Results: In training cohort of 30 patients with clinically positive lymph nodes the overall AUS+SWE sensitivity was set at 89.2%. The positive predictive value was calculated to be 96.1%. In the assessment of invasive breast tumors stages T1- T3 with clinically negative lymph nodes the sensitivity was 74.2%, specificity 95.5% positive predictive value was 85.2% and negative predictive value 91.4% If FNA or CNB follow the AUS+SWE in patients with CNLN the sensitivity was 86.7%, specificity 85.7% positive predictive value was 92.8% and negative predictive value was 75% (FNA or CNB was performed in 40 patients of 120 in validation set). Area under the ROC-curve was calculated as 0.860 [95% CI 0.766 to 0.954] for the US+SWE and 0.705 [95% CI 0.581 to 0.828] for the US+SWE followed by FNA or CNB. Conclusions: Axillary US+SWE should be included in the preoperative staging of all patients with invasive breast cancer. The addition US+SWE (not obviously followed by FNA or CNB) could lead to avoiding of unnecessary SNLB or ALND in patients with clinically and pathologically negative lymph nodes with negative predictive value of 91.4%. On the other hand in patients with US+SWE positive lymph nodes SNLB could also be skipped and the time interval to definitive therapy became shorter. Clinical trial information: BCA_US_SWE_001.

Negative predictive value of ipsilateral axillary ultrasound in the pre-operative assessment of invasive breast cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12080-e12080 ◽  
Author(s):  
Bita Ameri ◽  
Riti Kanesa-Thasan ◽  
Maysa M. Abu-Khalaf ◽  
Adam C. Berger ◽  
Tara Eisenberg ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Negative Predictive Value ◽  
Invasive Breast Cancer ◽  
Predictive Value ◽  
Lymph Node Biopsy ◽  
Axillary Lymph ◽  
Axillary Ultrasound ◽  
Node Biopsy

e12080 Objective: To determine if a negative preoperative axillary ultrasound predicts a negative sentinel lymph node biopsy at surgery. Background: Axillary lymph node involvement is an important prognostic indicator in patients with breast cancer. Sentinel lymph node biopsy (SLNB) is currently the gold standard for determining the presence or absence of axillary metastases. Pre-operative axillary ultrasound is often used to evaluate axillary lymph node status prior to surgery and SLNB. Although there are no established guidelines on when preoperative axillary ultrasound is performed, at our institution we evaluate the axilla when invasive breast cancer is suspected. This study evaluated the negative predictive value (NPV) of axillary ultrasound compared to the pathology results of SLNB. Methods: In this single-center IRB-approved retrospective study, 3 years of breast imaging data (2014-2016) were reviewed. 137 patients had pathology verified invasive breast cancer with negative preoperative axillary ultrasound and subsequent SLNB. All patients had clinically negative axillae. Based upon the pathology results of SLNB, the negative predictive value of preoperative axillary ultrasound was calculated. Negative axillary ultrasound is defined as the absence of morphologically abnormal lymph nodes on imaging. A lymph node is considered morphologically normal when there is preserved fatty hilum and a uniform cortex measuring 3 mm or less. Results: Out of 137 patients with invasive breast cancer who had negative preoperative axillary ultrasound, 122 had negative SLNB results and 15 had positive SLNB results. Preoperative axillary ultrasound demonstrated a NPV of 89.1% for the detection of axillary metastatic disease at the time of SLNB. Conclusions: Negative axillary ultrasound excluded axillary metastatic disease in 89.1% of patients. This data suggests that negative axillary ultrasound may have a role in the setting of failed SLNB (no lymph nodes found at the time of surgery) in deciding whether to pursue axillary dissection.

scholarly journals Ki67 and P53 expression in breast cancer and their correlation with clinicopathological parameters

2021 ◽  
Vol 8 (4) ◽  
pp. 478-484
Author(s):  
Sukanya Gogoi ◽  
Bandita Das ◽  
Mondita Borgohain ◽  
Gayatri Gogoi ◽  
Jayanta Das
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Menopausal Status ◽  
Clinicopathological Parameters ◽  
Lymph Node Status ◽  
P Value ◽  
Axillary Lymph ◽  
Ki 67 ◽  
P53 Expression ◽  
Node Status

Breast carcinoma is the most common malignancy in females and is a leading cause of death. Treatment depends upon various pathological and prognostic markers like lymph node status, size, type and grade of the tumour which influences the outcome of breast cancer. Markers like Ki-67 and p53 have been studied extensively and their roles in breast cancer are yet to be established.We evaluated the expression of Ki67 and P53 in breast cancer and their association with other clinico-pathological factors was studied. Ki67 and P53 expression was assessed in 60 breast cancer cases admitted to our hospital over a period of one year. Association with other prognostic parameters was evaluated. Statistical analysis was done by Chi square test and a p value of <0.05 was taken as significant. 43.33% cases had low proliferative Ki-67 score whereas 56.67% of the cases were highly proliferative. p53 expression was seen in 41.66% cases. Ki-67 and p53 expression were not significantly related to age, menopausal status, and tumour size whereas a significant correlation was seen with positive axillary lymph node status, high histological grade, negative hormone receptor status (ER, PR) and positive HER2/neu expression. Significant association was seen between Ki-67 and p53 expression.Ki67 and P53 may be considered as a valuable biomarker in breast cancer patients which can help in planning treatment strategies.

scholarly journals A Novel High-resolution Dedicated Axillary PET Improve Sensitivity in the Assessment of Regional Nodal Spread of Disease in Early Breast Cancer.

2020 ◽  
Author(s):  
Jingyi Cheng ◽  
Junjie Li ◽  
Guangyu Liu ◽  
Ruohong Shui ◽  
Sheng Chen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
High Resolution ◽  
Breast Carcinoma ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Axillary Lymph Node ◽  
False Negative ◽  
False Negative Rate ◽  
Axillary Lymph

Abstract Background: The aim of this study was to assess if a novel high-resolution dedicated axillary lymph node Positron Emission Tomography (LymphPET) system could improve sensitivity analysing Lymph Node involvement in early breast carcinoma with clinical N0-N1 stage. Methods: A total of 103 patients with clinical stage of T1-2N0-1M0 breast cancer were evaluated with LymphPET. The maximum single-voxel PET uptake value of Axillary Lymph Node (maxLUV) and the tumor-to-background ratio (TBR) for fat (TBR1) and muscle (TBR2) tissue were calculated. Then, seventy-eight patients with cN0 stage received sentinel lymph node biopsy (SLNB) alone or in combination with ALN dissection (ALND) and 25 patients with cN1 stage underwent fine-needle aspiration (FNA). Results: Ninety-nine invasive breast carcinoma entered this study. The diagnostic sensitivity of LymphPET was 87.80%, specificity was 79.31%, false-negative rate was 12.20%, false-positive rate was 20.69%, positive predictive value was 75.00%, negative predictive value was 90.20%, and accuracy was 82.83%. The maxLUV was superior to TBR1 and TBR2 in the detection of ALN, with 0.27 being the most optimal cutoff value. Conclusion: The 18F-FDG LymphPET could be used to identify and recognize more indolent ALNs of the breast cancer because of more sensitivity and much higher negative predictive value.

scholarly journals Role of Ultrasound in the Diagnosis of Lymph Node Status in Axillary Lymph Node Metastases in Breast Cancer undergoing Neoadjuvant Chemotherapy

2019 ◽  
Author(s):  
Yizhen Zhou ◽  
Lei Zhang ◽  
Zining Jin ◽  
Hailan Yu ◽  
Siyu Ren ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Predictive Value ◽  
Axillary Lymph Node ◽  
Lymph Node Status ◽  
Axillary Lymph ◽  
Short Axis ◽  
Breast Cancer Patients

Abstract Background:Axillary ultrasound (AUS) is one of the important bases for evaluating the axillary status of breast cancer patients. And it would be helpful for the reassessment of axillary lymph node status in these patients after neoadjuvant chemotherapy(NAC) and guide the selection of their axillary surgical options.The purpose of this study was to evaluate the diagnostic performance of ultrasound,and to find out the factors related to the outcome of ultrasound. Methods:In this retrospective analysis, 172 patients (one bilateral breast cancer) with breast cancer and clinical positive axillary nodes, were enrolled. After NAC, all patients received mastectomy and axillary lymph node dissection (ALND). AUS was used before and after NAC to assess the axilla status. Results:Of the 173 axillae, 137 (79.19%) had pathological metastasis after NAC. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of axillary ultrasound in this cohort were 68.21%, 69.34%, 63.89%, 87.96% and 35.38% respectively. Univariate analysis showed that primary axillary lymph node(ALN) short axis, progesterone receptors, hormone receptors, the tumor status after NAC, tumor reduction rate, ALN short axis after NAC, physical examination of axilla after NAC and pN impacted the results of AUS(P = 0.000 ~ 0.040). Multivariate analysis of the above indicators showed that ALN short axis after NAC and pN associated with AUS results independently. Conclusion:AUS can accurately assess axilla status after NAC in most breast cancer patients. If the short axis of ALN≥10mm and AUS negative, SLNB could be chosen. However, AUS cannot detect residual lymph node disease after NAC in a short axis of the ALN <10mm.

scholarly journals Clinical implications of intrinsic molecular subtypes of breast cancer for sentinel node status

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maria Rossing ◽  
Christina Bligaard Pedersen ◽  
Tove Tvedskov ◽  
Ilse Vejborg ◽  
Maj-Lis Talman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Node ◽  
Predictive Value ◽  
Hormone Receptor ◽  
Molecular Subtypes ◽  
Receptor Activity ◽  
Lymph Node Status ◽  
Breast Cancers ◽  
Node Status

AbstractAxillary lymph node status is an important prognostic factor for breast cancer patients and sentinel lymph node biopsy (SLNB) is a less invasive surgical proxy. We examined if consecutively derived molecular subtypes from primary breast cancers provide additional predictive value for SLNB status. 1556 patients with a breast cancer > 10 mm underwent primary surgical procedure including SLNB and tumor specimens were assigned with a transcriptomics-based molecular subtype. 1020 patients had a negative sentinel node (SN) and 536 a positive. A significant association between tumor size and SN status (p < 0.0001) was found across all samples, but no association between size and SN status (p = 0.14) was found for BasL tumors. A BasL subtype was a predictor of an SN-negative status (p = 0.001, OR 0.58, 95% CI 0.38;0.90) and among the BasL, postmenopausal status was a predictor for SN-negative status (p = 0.01). Overall survival was significantly lower (p = 0.02) in patients with BasL tumors and a positive SN. Interestingly, we identified a significant correlation between hormone receptor activity and SN status within the BasL subtype. Taken together, molecular subtypes and hormone receptor activity of breast cancers add predictive value for SLNB status.

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