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The potential of combined shear wave and strain elastography to reduce unnecessary biopsies in breast cancer diagnostics: an international, multicentre trial

Background - Shear wave elastography (SWE) and strain elastography (SE) have shown promising potential in breast cancer diagnostics by evaluating the stiffness of a lesion. Combining these two techniques could further improve the diagnostic performance. We aimed to exploratorily define the cut-offs...

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Main Authors: Golatta, Michael (Author) , Pfob, André (Author) , Büsch, Christopher (Author) , Bruckner, Thomas (Author) , Alwafai, Zaher (Author) , Balleyguier, Corinne (Author) , Clevert, Dirk-André (Author) , Duda, Volker (Author) , Goncalo, Manuela (Author) , Gruber, Ines (Author) , Hahn, Markus (Author) , Kapetas, Panagiotis (Author) , Ohlinger, Ralf (Author) , Rutten, Matthieu (Author) , Togawa, Riku (Author) , Tozaki, Mitsuhiro (Author) , Wojcinski, Sebastian (Author) , Rauch, Geraldine (Author) , Heil, Jörg (Author) , Barr, Richard G. (Author)
Format: Article (Journal)
Language:English
Published: 2022
In: European journal of cancer
Year: 2022, Volume: 161, Pages: 1-9
ISSN:1879-0852
DOI:10.1016/j.ejca.2021.11.005
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.ejca.2021.11.005
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0959804921012156
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Author Notes:Michael Golatta, André Pfob, Christopher Büsch, Thomas Bruckner, Zaher Alwafai, Corinne Balleyguier, Dirk-André Clevert, Volker Duda, Manuela Goncalo, Ines Gruber, Markus Hahn, Panagiotis Kapetas, Ralf Ohlinger, Matthieu Rutten, Riku Togawa, Mitsuhiro Tozaki, Sebastian Wojcinski, Geraldine Rauch, Joerg Heil, Richard G. Barr
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Summary:Background - Shear wave elastography (SWE) and strain elastography (SE) have shown promising potential in breast cancer diagnostics by evaluating the stiffness of a lesion. Combining these two techniques could further improve the diagnostic performance. We aimed to exploratorily define the cut-offs at which adding combined SWE and SE to B-mode breast ultrasound could help reclassify Breast Imaging Reporting and Data System (BI-RADS) 3-4 lesions to reduce the number of unnecessary breast biopsies. - Methods - We report the secondary results of a prospective, multicentre, international trial (NCT02638935). The trial enrolled 1288 women with BI-RADS 3 to 4c breast masses on conventional B-mode breast ultrasound. All patients underwent SWE and SE (index test) and histopathologic evaluation (reference standard). Reduction of unnecessary biopsies (biopsies in benign lesions) and missed malignancies after recategorising with SWE and SE were the outcome measures. - Results - On performing histopathologic evaluation, 368 of 1288 breast masses were malignant. Following the routine B-mode breast ultrasound assessment, 53.80% (495 of 920 patients) underwent an unnecessary biopsy. After recategorising BI-RADS 4a lesions (SWE cut-off ≥3.70 m/s, SE cut-off ≥1.0), 34.78% (320 of 920 patients) underwent an unnecessary biopsy corresponding to a 35.35% (320 versus 495) reduction of unnecessary biopsies. Malignancies in the new BI-RADS 3 cohort were missed in 1.96% (12 of 612 patients). - Conclusion - Adding combined SWE and SE to routine B-mode breast ultrasound to recategorise BI-RADS 4a patients could help reduce the number of unnecessary biopsies in breast diagnostics by about 35% while keeping the rate of undetected malignancies below the 2% ACR BI-RADS 3 definition.
Item Description:Available online 5 December 2021
Gesehen am 09.08.2022
Physical Description:Online Resource
ISSN:1879-0852
DOI:10.1016/j.ejca.2021.11.005

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