Pre-operative stromal stiffness measured by shear wave elastography is independently associated with breast cancer-specific survival.
Sim, Yee Ting
Breast Cancer Res Treat
Springer Science and Business Media LLC
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Evans, A., Sim, Y. T., Pourreyron, C., Thompson, A., Jordan, L., Fleming, D., Purdie, C., et al. (2018). Pre-operative stromal stiffness measured by shear wave elastography is independently associated with breast cancer-specific survival.. Breast Cancer Res Treat, 171 (2), 383-389. https://doi.org/10.1007/s10549-018-4836-5
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.
Humans, Breast Neoplasms, Neoplasm Staging, Prognosis, Elasticity, Adult, Aged, Aged, 80 and over, Middle Aged, Female, Elasticity Imaging Techniques, Preoperative Period, Kaplan-Meier Estimate, Tumor Microenvironment, Neoplasm Grading, Biomarkers
Cancer Research Uk (None)
External DOI: https://doi.org/10.1007/s10549-018-4836-5
This record's URL: https://www.repository.cam.ac.uk/handle/1810/283403
Attribution 4.0 International
Licence URL: https://creativecommons.org/licenses/by/4.0/