Application value of conventional ultrasound combined with shear wave elastography in diagnosing triple negative...

At present, most ultrasound (US) studies on triple negative breast cancer (TNBC) are limited to conventional US features, so it is necessary to develop new joint diagnostic methods. The study aims to explore the values of conventional US and shear wave elastography (SWE) in differential diagnoses of TNBC and non-TNBC.

A total of 120 breast cancer (BC) patients involving 120 lesions that were pathologically verified were retrospectively analyzed in this study. All participants had received both conventional US and SWE before surgery. Meanwhile, the participants were divided into a TNBC group or a non-TNBC group according to their immunohistochemical (IHC) results. The differences between the conventional US features (including lesion shape, growth location, margin, boundary, internal echo, micro-calcification, posterior echo, and internal blood supply) and the SWE image features [including mean lesion hardness (Emean), maximum (Emax), minimum (Emin), standard deviation (SD), and ratio to normal gland (Eratio)] of 2 groups were compared. The receiver operating characteristic (ROC) curve of the diagnosed lesion was calculated by the area under the curve (AUC).

According to the findings of conventional US, the TNBC group mostly manifested as a micro-lobulated margin, with a clear boundary and no internal micro-calcification; the non-TNBC group mainly manifested as marginal angulation or burr, and hyper-echo halo in the boundary, accompanied with internal micro-calcification, and the difference was statistically significant (P<0.05); the internal thrombolysis in myocardial infarction (TIMI) and resistance index between the TNBC group and non-TNBC group were similar, and the differences were not statistically significant (P>0.05). The findings of SWE were as follows: differences in Emax, Emean, and Eratio values between 2 groups were statistically significant (P<0.05); and the areas under the ROC curve (AUC) of these three in diagnosing the lesions were 0.811, 0.781 and 0.770, respectively.

Conventional US combined with SWE can comprehensively analyze the morphological, blood supply, and hardness features of breast lesions, and provide more reliable information for the differential diagnosis between TNBC and non-TNBC.