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Pre-operative stromal stiffness measured by shear wave elastography is independently associated with breast cancer-specific survival
INTRODUCTION: With the increased use of neoadjuvant therapy for breast cancer, there is a need for pre-operative prediction of prognosis. We aimed to assess the prognostic value of tumour stiffness measured by ultrasound shear wave elastography (SWE). METHODS: A consecutive cohort of patients with i...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6096877/ https://www.ncbi.nlm.nih.gov/pubmed/29858751 http://dx.doi.org/10.1007/s10549-018-4836-5 |
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author | Evans, Andy Sim, Yee Ting Pourreyron, Celine Thompson, Alastair Jordan, Lee Fleming, Dawn Purdie, Colin Macaskill, Jane Vinnicombe, Sarah Pharoah, Paul |
author_facet | Evans, Andy Sim, Yee Ting Pourreyron, Celine Thompson, Alastair Jordan, Lee Fleming, Dawn Purdie, Colin Macaskill, Jane Vinnicombe, Sarah Pharoah, Paul |
author_sort | Evans, Andy |
collection | PubMed |
description | INTRODUCTION: With the increased use of neoadjuvant therapy for breast cancer, there is a need for pre-operative prediction of prognosis. We aimed to assess the prognostic value of tumour stiffness measured by ultrasound shear wave elastography (SWE). METHODS: A consecutive cohort of patients with invasive breast cancer underwent breast ultrasound (US) including SWE. The following were recorded prospectively: US diameter, stiffness at SWE, presentation source, core biopsy grade, oestrogen receptor (ER) status and pre-operative nodal status. Breast cancer-specific survival (BCSS) was analysed with regard to US size and stiffness, tumour grade on core biopsy, ER status, presentation mode and pre-operative nodal status. Analysis used Cox proportional hazards regression. RESULTS: Of the 520 patients, 42 breast cancer and 53 non-breast cancer deaths were recorded at mean follow-up of 5.4 years. Hazard ratios (HR) for tertiles of stiffness were 1, 4.8 and 8.1 (P = 0.0001). HR for 2 groups based on US size < or ≥ 20 mm were 1 and 5.1 (P < 0.0001). HR for each unit increase in tumour grade on core biopsy was 3.9 (P < 0.0001). The HR for ER positivity compared to ER negativity was 0.21 (P < 0.001). BCSS was also associated with presentation mode and pre-operative nodal status. In a multivariable model, stiffness, US size and ER status were independently associated with BCSS. CONCLUSION: Multiple pre-operative factors including stromal stiffness at SWE have independent prognostic significance. A larger dataset with longer follow-up could be used in the future to construct a pre-operative prognostic model to guide treatment decisions. |
format | Online Article Text |
id | pubmed-6096877 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-60968772018-08-24 Pre-operative stromal stiffness measured by shear wave elastography is independently associated with breast cancer-specific survival Evans, Andy Sim, Yee Ting Pourreyron, Celine Thompson, Alastair Jordan, Lee Fleming, Dawn Purdie, Colin Macaskill, Jane Vinnicombe, Sarah Pharoah, Paul Breast Cancer Res Treat Clinical Trial INTRODUCTION: With the increased use of neoadjuvant therapy for breast cancer, there is a need for pre-operative prediction of prognosis. We aimed to assess the prognostic value of tumour stiffness measured by ultrasound shear wave elastography (SWE). METHODS: A consecutive cohort of patients with invasive breast cancer underwent breast ultrasound (US) including SWE. The following were recorded prospectively: US diameter, stiffness at SWE, presentation source, core biopsy grade, oestrogen receptor (ER) status and pre-operative nodal status. Breast cancer-specific survival (BCSS) was analysed with regard to US size and stiffness, tumour grade on core biopsy, ER status, presentation mode and pre-operative nodal status. Analysis used Cox proportional hazards regression. RESULTS: Of the 520 patients, 42 breast cancer and 53 non-breast cancer deaths were recorded at mean follow-up of 5.4 years. Hazard ratios (HR) for tertiles of stiffness were 1, 4.8 and 8.1 (P = 0.0001). HR for 2 groups based on US size < or ≥ 20 mm were 1 and 5.1 (P < 0.0001). HR for each unit increase in tumour grade on core biopsy was 3.9 (P < 0.0001). The HR for ER positivity compared to ER negativity was 0.21 (P < 0.001). BCSS was also associated with presentation mode and pre-operative nodal status. In a multivariable model, stiffness, US size and ER status were independently associated with BCSS. CONCLUSION: Multiple pre-operative factors including stromal stiffness at SWE have independent prognostic significance. A larger dataset with longer follow-up could be used in the future to construct a pre-operative prognostic model to guide treatment decisions. Springer US 2018-06-01 2018 /pmc/articles/PMC6096877/ /pubmed/29858751 http://dx.doi.org/10.1007/s10549-018-4836-5 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Clinical Trial Evans, Andy Sim, Yee Ting Pourreyron, Celine Thompson, Alastair Jordan, Lee Fleming, Dawn Purdie, Colin Macaskill, Jane Vinnicombe, Sarah Pharoah, Paul Pre-operative stromal stiffness measured by shear wave elastography is independently associated with breast cancer-specific survival |
title | Pre-operative stromal stiffness measured by shear wave elastography is independently associated with breast cancer-specific survival |
title_full | Pre-operative stromal stiffness measured by shear wave elastography is independently associated with breast cancer-specific survival |
title_fullStr | Pre-operative stromal stiffness measured by shear wave elastography is independently associated with breast cancer-specific survival |
title_full_unstemmed | Pre-operative stromal stiffness measured by shear wave elastography is independently associated with breast cancer-specific survival |
title_short | Pre-operative stromal stiffness measured by shear wave elastography is independently associated with breast cancer-specific survival |
title_sort | pre-operative stromal stiffness measured by shear wave elastography is independently associated with breast cancer-specific survival |
topic | Clinical Trial |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6096877/ https://www.ncbi.nlm.nih.gov/pubmed/29858751 http://dx.doi.org/10.1007/s10549-018-4836-5 |
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