A Prospective Two Center Study Comparing Breast Cancer Lesion Size Defined by 2D Shear Wave Elastography, B-Mode Ultrasound, and Mammography with the Histopathological Size

Abstract

Purpose The aim of the present study was to determine the accuracy of breast cancer measurement with 2 D shear wave elastography (2 D SWE), B-mode ultrasound, and mammography by comparing these methods with the actual histopathological tumor size.

Materials and Methods 135 patients with proven malignant breast lesions at two centers were included in a prospective study. The maximum lesion diameter was measured by 2 D SWE, B-mode ultrasound, and mammography. After surgery, the histopathological tumor size was measured by a pathologist.

Results The mean difference in tumor size on 2 D SWE, B-mode ultrasound, and mammography on the one hand, and the actual tumor size on the other, was –0.03 cm, 0.16 cm and 0.10 cm, respectively. Lesion size on histopathological investigation was overestimated by 2 D SWE (p = 0.004) and underestimated by B-mode imaging (p < 0.001). All three imaging methods underestimated the size of invasive lobular cancers and lesions > 15 mm; 2 D SWE was most accurate in this regard.

Conclusion 2 D SWE predicted lesion size more precisely than B-mode ultrasound or mammography. In cases of invasive lobular carcinoma, all three imaging methods underestimated lesion size, with 2 D SWE coming closest to the actual tumor size.

Zusammenfassung

Ziel Ziel der Studie ist es, die Genauigkeit der Brustkrebsgrößenmessung mittels 2D-Scherwellenelastografie (2D-SWE), B-Bild-Ultraschall und Mammografie zu evaluieren und mit der tatsächlichen histopathologischen Tumorgröße zu vergleichen.

Material und Methode Diese an 2 Zentren durchgeführte prospektive Studie umfasste 135 Patienten mit nachgewiesenen malignen Brusttumoren. Der maximale Durchmesser wurde mittels 2D-SWE, B-Bild-Ultraschall und Mammografie gemessen. Nach operativer Entfernung der Tumoren wurde die histopathologische Tumorgröße von den Pathologen gemessen und als Goldstandard zum Vergleich mit den bildgebenden Messungen verwendet.

Ergebnisse Die mittlere Differenz zwischen der gemessenen und der tatsächlichen Tumorgröße für 2D-SWE, B-Bild-Ultraschall und Mammografie betrug –0,03 cm, 0,16 cm bzw. 0,10 cm. Die 2D-SWE überschätzt (p = 0,004), während der B-Bild-Ultraschall (p < 0,001) die Größe der histopathologischen Veränderung unterschätzt. Alle 3 bildgebenden Verfahren unterschätzen die Ausdehnung invasiv lobulärer Karzinome und Tumoren > 15 mm, wobei die 2D-SWE hier am genauesten misst.

Schlussfolgerungen Die Größenmessung maligner Brusttumoren ist mit der 2D-SWE genauer als mit dem B-Bild-Ultraschall und der Mammografie. Bei invasiv lobulären Karzinomen unterschätzen alle 3 bildgebenden Verfahren die tatsächliche Größe des Tumors, wobei die 2D-SWE der tatsächlichen Tumorgröße am nächsten kommt.

Key words

breast - elastography - lesion size - shearwave

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