Abstract
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.
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Acknowledgment
This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2013R1A1A2058789). The authors thank Kyung Sook Yang for her excellent advice on statistical analysis and Chris Woo, B.A., for his kind assistance in editing this manuscript.
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Lee, S.H., Chang, J.M., Han, W. et al. Shear-Wave Elastography for the Detection of Residual Breast Cancer After Neoadjuvant Chemotherapy. Ann Surg Oncol 22 (Suppl 3), 376–384 (2015). https://doi.org/10.1245/s10434-015-4828-1
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DOI: https://doi.org/10.1245/s10434-015-4828-1