Shear‐Wave Elastography‐Guided Core Needle Biopsy for the Determination of Breast Cancer Molecular Subtype

Abstract

Objective To investigate whether shear‐wave elastography (SWE) guidance during core‐needle biopsy can improve diagnostic accuracy and accurate determination of the molecular subtypes of breast cancer. Methods This controlled, randomized prospective cohort study included 58 patients (mean age: 56.9 ± 16.2) who were referred for image‐guided core‐needle biopsy between May 2018 and April 2019 for lesions larger than 1 cm. In Group 1, 30 lesions were biopsied without SWE guidance and recorded as Biopsy A. In Group 2, 30 lesions were examined with SWE before biopsy, and then two different parts of the lesions were biopsied; biopsies from the relatively rigid areas of the lesions were recorded as Biopsy B, and biopsies from the less rigid areas of the lesions were recorded as Biopsy C. The histopathological and immunohistochemical results of biopsies were compared with the surgical results. Results The sensitivity of Biopsy A, B and C were 96.7%, 100% and 100%, respectively. The benign‐malignant concordance rates were 94.7%, 100%, and 90% and the diagnostic concordance rates were 89.5%, 100%, and 90% in Biopsies A, B, and C, respectively. When the 10% differences in the estrogen receptor (ER), progesterone receptor (PR), and Ki67 rates were considered significant, the concordance rate of ER was highest in Biopsy B (77.8%; p = 0.040). The concordance rate of immunohistochemical subtyping was 100% in Biopsy B and 71.4% in Biopsies A and C (p = 0.086). Conclusion SWE‐guided core‐needle biopsy of breast lesions increased the sensitivity, diagnostic accuracy, and accuracy of immunohistochemical subtyping to 100%.

The Diagnostic Role of Shear Wave Elastography and Superb Microvascular Imaging in the Evaluation of Suspicious Microcalcifications

“…In daily practice, SWE is frequently used to differentiate between BI‐RADS 4a and BI‐RADS 3 masses 14 . It is also useful in radiological–pathological correlation and can help avoid underestimation of core biopsy 11 . Generally, 80 kPa is used as the cut‐off value for SWE in differentiating malignancy 14,27–29 .…”

Comparing the accuracy of shear wave elastography and strain elastography in the diagnosis of breast tumors: A systematic review and meta-analysis

“…[10] These results indicate that ultrasound elastography is promising in diagnosing breast lesions, especially BI-RADS type 4 lesions, but elastography cannot replace the conventional US. [23,24] Combining the conventional US with elastography can improve the performance of the diagnosis of breast lesions. Therefore, it is necessary to find a more effective elastography method in the 2 kinds of elastography to identify the characteristics of tumor lesions and the differentiation of benign and malignant lesions.…”

Shear Wave Elastography-Assisted Ultrasound Breast Image Analysis and Identification of Abnormal Data

“…e diversity of pathological histology, gross staging, and immunohistochemical features of the breast cancer causes the sonographic presentation of breast cancer lesions to be complex and variable as well [5]. Especially, the early biological features and ultrasound manifestations of small breast masses are extremely atypical, or when early breast cancer masses do not show typical sonographic manifestations, they bring confusion to ultrasound diagnosis.…”