Shear-Wave Elastography for the Detection of Residual Breast Cancer After Neoadjuvant Chemotherapy

• Published in: Annals of surgical oncology Vol. 22; no. Suppl 3; pp. 376 - 384
• Main Authors: Lee, Su Hyun, Chang, Jung Min, Han, Wonshik, Moon, Hyeong-Gon, Koo, Hye Ryoung, Gweon, Hye Mi, Kim, Won Hwa, Noh, Dong-Young, Moon, Woo Kyung
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.12.2015; Springer Nature B.V
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - pathology; Breast Oncology; Elasticity Imaging Techniques - methods; Female; Follow-Up Studies; Humans; Medicine; Medicine & Public Health; Middle Aged; Neoadjuvant Therapy; Neoplasm Staging; Neoplasm, Residual - diagnosis; Oncology; Prognosis; Retrospective Studies; ROC Curve; Surgery; Surgical Oncology; Ultrasonography, Mammary - methods; Residual Cancer; Residual Lesion; Breast Magnetic Resonance Imaging; Mammographic Finding; Residual Tumor Size
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1245/s10434-015-4828-1

Objective This study was designed to evaluate the accuracy of shear-wave elastography (SWE) in the detection of residual breast cancer after neoadjuvant chemotherapy (NAC). Methods Seventy-one women with stage II-III breast cancers who underwent B-mode ultrasound (US), SWE, and magnetic resonance imaging (MRI) after NAC were included. The presence of residual cancer was determined on B-mode US and MRI, and the maximum elasticity of residual lesions was assessed on SWE. The sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve (AUC) of B-mode US, SWE, and MRI were compared. Results Sixty-one of 71 women (86 %) had residual cancer and showed higher maximum elasticity values (mean 116.0 ± 74.1 kPa) than those without residual cancer (26.4 ± 21.0 kPa; p  < 0.001). B-mode US showed 72.1 % (44/61) sensitivity, 50.0 % (5/10) specificity, and 69.0 % (49/71) accuracy. The sensitivity, specificity, and accuracy of SWE were 83.6 % (51/61), 80.0 % (8/10), and 83.1 % (59/71) when a maximum elasticity value of >30 kPa was considered to indicate the presence of residual cancer. The combined AUC of B-mode US and SWE (0.877) was significantly higher than that of B-mode US (0.702) ( p  = 0.014) and comparable to that of MRI (0.939) ( p  = 0.147). Conclusions SWE allowed relatively accurate assessment for the presence of residual lesion after NAC and improved the diagnostic performance of B-mode US.