Diagnosis of sub-centimetre breast lesions: combining BI-RADS-US with strain elastography and contrast-enhanced ultrasound—a preliminary study in China

Xiao, Xiaoyun; Jiang, Qiongchao; Wu, Huan; Guan, Xu; Qin, Wei; Luo, Baoming

doi:10.1007/s00330-016-4628-4

Cited by 66 publications

(46 citation statements)

References 32 publications

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“…To evaluate differences related to the ethnicity of patients enrolled in the study and variation related to ultrasonography itself, we determined the cutoff value for ultrasound-based BI-RADS scores and PD-1 mRNA expression using ROC curves. The sensitivity and specificity for BI-RADS scores were 0.752 and 0.909, respectively, and AUC was 0.906 (0.860–0.952), with a cutoff value for BI-RADS 4C, which is consistent with previous studies 8,49…”

Section: Discussionsupporting

confidence: 90%

“…Breast ultrasound is a routine and valuable measure to differentiate malignant and benign breast tumors 8,47. Jeffers et al4 predicted breast cancer risks by BI-RADS classification, with an AUC of 0.68.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical breast examinations and radiological studies are established as essential tools for early detection and are associated with significant improvements in patient outcomes 4,6–8. According to the 5th edition of Breast Imaging Reporting and Data System (BI-RADS) classification, there are BI-RADS 1–6 for tumor diagnosis 9.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic value of PD-1 mRNA expression combined with breast ultrasound in breast cancer patients

Fang

Shao

et al. 2018

TCRM

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IntroductionThis study explored the value of measuring programmed death 1 (PD-1) in peripheral blood, combined with breast ultrasound using the Breast Imaging Reporting and Data System (BI-RADS) classification, for differentiation between benign and malignant breast tumors.Materials and methodsWe enrolled 113 patients with breast cancer and 66 patients with benign breast tumors who were admitted to Hangzhou First People’s Hospital from September 2014 to August 2017. The mRNA level of PD-1 was detected by quantitative real-time polymerase chain reaction.ResultsThe mRNA levels of PD-1 were significantly higher in the peripheral blood of patients with breast cancer than those in patients with benign breast tumors. The diagnostic sensitivity of PD-1 mRNA expression was 0.805, the specificity was 0.788, and the area under the curve (AUC) was 0.848 (P < 0.001); the sensitivity of breast ultrasound-based BI-RADS classification was 0.752, the specificity was 0.909, and the AUC was 0.906 (P < 0.001); and the combined sensitivity, specificity, and AUC of the two assays were 0.920, 0.879, and 0.938, respectively (P < 0.001). Progesterone receptor-positive breast cancer patients exhibited high levels of PD-1 expression (P < 0.001).ConclusionThis study suggests that the measurement of PD-1 combined with breast ultrasound-based BI-RADS classification represents a significant improvement for breast cancer diagnosis compared with diagnoses based on either method alone.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Diagnostic value of PD-1 mRNA expression combined with breast ultrasound in breast cancer patients

Fang

Shao

et al. 2018

TCRM

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“…This is in keeping with the recent study of Park et al investigating shear wave elastography of breast non‐mass lesions, showing that smaller lesion size of malignant lesions are associated with false negative results . The addition of contrast‐enhanced US, in combination with strain elastography is a promising technique which has been shown to improve diagnostic performances in case of small breast lesions . With respect to tumor histologic features, malignant lesions that are soft, such as DCIS, necrotic tumors and mucinous carcinoma can be misclassified as benign.…”

Section: Discussionsupporting

confidence: 79%

Can strain elastography improve the characterization of breast lesions identified during second‐look MRI‐directed sonographic examination?

Filip

Ferré

AlSharif

et al. 2019

J of Clinical Ultrasound

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Purpose To evaluate strain elastography as a complementary tool for characterization of lesions identified during second‐look MRI‐directed sonographic examination. Methods We reviewed 83 breast lesions evaluated with MRI, secondlook ultrasound (US) and strain elastography in 75 consecutive patients (median age, 56 years). US‐guided biopsies were performed in all cases. Results After histopathological examination, 44 lesions were benign, 38 were malignant and 1 was high‐risk. At MRI, the mean size of the lesions was 12 mm. Forty lesions (48.2%) appeared as masses, 30 (36.1%) as “non‐masses” and 13 (15.7%) as “foci.” At second‐look US examination, 56 (67.5%) appeared as masses (mean size, 7 mm) and 27 (32.5%) as non‐masses (mean size, 14 mm). At strain elastography, among the 39 malignant/high risk lesions, 5 (12.8%) had a score of 4 or 5, whereas 16 (41%) had a score of 1 and 2 (false negative). Among the 44 benign lesions, 36 (82%) had a score of 1 or 2, whereas none had a score of 5. Sensitivity and specificity of strain elastography in the diagnosis of breast cancer were 58% and 81%, respectively. Conclusion The addition of strain elastography offers no benefit in the characterization of lesions identified on second‐look US after breast MRI.(E1, 3).

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“…Additionally, a relationship has been found between the elasticity imaging/B-mode ratio on SE and tumor grades in breast cancer [22]. A recent preliminary study has indicated that Contrast Enhanced Ultrasound (CEUS) provides superior diagnostic performance in sub-centimetre breast lesions, offering promising alternatives to biopsy [33]. Given these updates in the field of sonoelastography, we set out to explore the relationship between lesion size and the influence of SE on ILC classification, in order to identify an optimal size threshold at which SE adds significantly more value to the examination.…”

Section: Discussionmentioning

confidence: 99%

Impact of Strain Elastography on BI-RADS classification in small invasive lobular carcinoma

Chiorean

Szep²,

Feier

et al. 2018

Med Ultrason

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Aims: The purpose of this study was to determine the impact of strain elastography (SE) on the Breast Imaging Reporting Data System (BI-RADS) classification depending on invasive lobular carcinoma (ILC) lesion size.Materials and methods: We performed a retrospective analysis on a sample of 152 female subjects examined between January 2010 – January 2017. SE was performed on all patients and ILC was subsequently diagnosed by surgical or ultrasound-guided biopsy. BI-RADS 1, 2, 6 and Tsukuba BGR cases were omitted. BI-RADS scores were recorded before and after the use of SE. The differences between scores were compared to the ILC tumor size using nonparametric tests and logistic binary regression. We controlled for age, focality, clinical assessment, heredo-collateral antecedents, B-mode and Doppler ultrasound examination. An ROC curve was used to identify the optimal cut-off point for size in relationship to BI-RADS classificationdifference using Youden’s index.Results: The histological subtypes of ILC lesions (n=180) included in the sample were luminal A (70%, n=126), luminal B (27.78%, n=50), triple negative (1.67%, n=3) and HER2+ (0.56%, n=1). The BI-RADS classification was higher when SE was performed (Z=- 6.629, p<0.000). The ROC curve identified a cut-off point of 13 mm for size in relationship to BI-RADS classification difference (J=0.670, p<0.000). Small ILC tumors were 17.92% more likely to influence BI-RADS classification (p<0.000).Conclusions: SE offers enhanced BI-RADS classification in small ILC tumors (<13 mm). Sonoelastography brings added value to B-mode breast ultrasound as an adjacent to mammography in breast cancer screening.

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Diagnosis of sub-centimetre breast lesions: combining BI-RADS-US with strain elastography and contrast-enhanced ultrasound—a preliminary study in China

Abstract: • Evaluating breast lesions with SE and CEUS could increase the diagnostic specificity • SE and CEUS offer alternatives to biopsy and possibly allow shorter-interval follow-ups • BI-RADS-US combined with CEUS exhibited the best diagnostic performance.

Cited by 66 publications

References 32 publications

Diagnostic value of PD-1 mRNA expression combined with breast ultrasound in breast cancer patients

Diagnostic value of PD-1 mRNA expression combined with breast ultrasound in breast cancer patients

Can strain elastography improve the characterization of breast lesions identified during second‐look MRI‐directed sonographic examination?

Impact of Strain Elastography on BI-RADS classification in small invasive lobular carcinoma

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