Pre-operative stromal stiffness measured by shear wave elastography is independently associated with breast cancer specific survival

Andy Evans (Lead / Corresponding author), Yee Ting Sim, Celine Pourreyron, Alastair Thompson, Lee Jordan, Dawn Fleming, Colin Purdie, Jane Macaskill, Sarah Vinnicombe, Paul Pharoah

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Abstract

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.
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
Original languageEnglish
Pages (from-to)383-389
Number of pages7
JournalBreast Cancer Research and Treatment
Volume171
Issue number2
Early online date1 Jun 2018
DOIs
Publication statusPublished - 1 Jun 2018

Keywords

  • Breast cancer
  • Prognosis
  • Shear wave elastography
  • Ultrasound
  • Neoadjuvant chemotherapy

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