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

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cam.issuedOnline2018-06
dc.contributor.authorEvans, Andy
dc.contributor.authorSim, Yee Ting
dc.contributor.authorPourreyron, Celine
dc.contributor.authorThompson, Alastair
dc.contributor.authorJordan, Lee
dc.contributor.authorFleming, Dawn
dc.contributor.authorPurdie, Colin
dc.contributor.authorMacaskill, Jane
dc.contributor.authorVinnicombe, Sarah
dc.contributor.authorPharoah, Paul
dc.contributor.orcidPharoah, Paul [0000-0001-8494-732X]
dc.date.accessioned2018-10-10T05:18:13Z
dc.date.available2018-10-10T05:18:13Z
dc.date.issued2018-09
dc.description.abstractINTRODUCTION: 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.
dc.format.mediumPrint-Electronic
dc.identifier.doi10.17863/CAM.30771
dc.identifier.eissn1573-7217
dc.identifier.issn0167-6806
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/283403
dc.languageeng
dc.language.isoeng
dc.publisherSpringer Science and Business Media LLC
dc.publisher.urlhttp://dx.doi.org/10.1007/s10549-018-4836-5
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectBreast cancer
dc.subjectNeoadjuvant chemotherapy
dc.subjectPrognosis
dc.subjectShear wave elastography
dc.subjectUltrasound
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectBiomarkers
dc.subjectBreast Neoplasms
dc.subjectElasticity
dc.subjectElasticity Imaging Techniques
dc.subjectFemale
dc.subjectHumans
dc.subjectKaplan-Meier Estimate
dc.subjectMiddle Aged
dc.subjectNeoplasm Grading
dc.subjectNeoplasm Staging
dc.subjectPreoperative Period
dc.subjectPrognosis
dc.subjectTumor Microenvironment
dc.titlePre-operative stromal stiffness measured by shear wave elastography is independently associated with breast cancer-specific survival.
dc.typeArticle
dcterms.dateAccepted2018-05-25
prism.endingPage389
prism.issueIdentifier2
prism.publicationDate2018
prism.publicationNameBreast Cancer Res Treat
prism.startingPage383
prism.volume171
pubs.funder-project-idCancer Research Uk (None)
rioxxterms.licenseref.startdate2018-09
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.typeJournal Article/Review
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1007/s10549-018-4836-5

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