Andrew Evans MRCP, FRCR, Presenter: Nothing to Disclose

Patsy Whelehan MSc, Abstract Co-Author: Consultant, General Electric Company

Petra Rauchhaus, Abstract Co-Author: Nothing to Disclose

Colin Puride, Abstract Co-Author: Nothing to Disclose

Lee Jordan, Abstract Co-Author: Nothing to Disclose

Kim Thomson, Abstract Co-Author: Nothing to Disclose

Sarah Jane Vinnicombe MRCP, FRCR, Abstract Co-Author: Nothing to Disclose

Shear wave elastography shows promise as an adjunct to greyscale ultrasound in assessing breast masses. In breast cancer, higher lesion stiffness values have been shown to be associated with poor prognostic features. The purpose of this study was to assess whether higher lesion stiffness at shear wave elastography is an independent predictor of lymph node involvement

Patients with invasive breast cancer treated by primary surgery, who had undergone shear wave elastography examination at the time of diagnosis, were eligible. Data were retrospectively analysed from 396 consecutive patients meeting these criteria. The mean stiffness values were obtained using the Aixplorer® ultrasound machine from SuperSonic Imagine Ltd. Measurements were taken from a region of interest positioned over the area identified via the colour map as the stiffest part of the abnormality. The average of the mean values obtained in each of four projections was used for analysis. Associations between lymph node involvement and mean lesion stiffness in kilopascals, invasive cancer size, histological grade, tumour type, ER and HER-2 receptor status and vascular invasion were assessed using univariate and multivariate logistic regression. Results  

Median age was 62 years, median invasive tumour size was 19 mm and 28% of patients had lymph node involvement. At univariate analysis, invasive size, histological grade, HER-2 status, vascular invasion, tumour type and mean stiffness were significantly associated with nodal involvement. At multivariate analysis, invasive size, tumour type, vascular invasion and mean stiffness maintained independent significance.

Mean stiffness at shear wave elastography is an independent predictor of lymph node metastasis in women with invasive breast cancer.

High tumor stiffness at shear wave elastography increases the risk of lymph node metastasis in women with invasive breast cancer.

Evans, A, Whelehan, P, Rauchhaus, P, Puride, C, Jordan, L, Thomson, K, Vinnicombe, S, Are Shear Wave Ultrasound Findings an Independent Predictor of Lymph Node Involvement in Women with Invasive Breast Cancer?.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13019640.html