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Lesion stiffness measured by shear-wave elastography: Preoperative predictor of the histologic underestimation of US-guided core needle breast biopsy

 Ah Young Park  ;  Eun Ju Son  ;  Jeong-Ah Kim  ;  Kyunghwa Han  ;  Ji Hyun Youk 
 EUROPEAN JOURNAL OF RADIOLOGY, Vol.84(12) : 2509-2514, 2015 
Journal Title
Issue Date
Adult ; Biopsy, Large-Core Needle ; Breast/pathology ; Breast Neoplasms/diagnostic imaging* ; Breast Neoplasms/pathology* ; Elasticity Imaging Techniques/methods* ; Female ; Humans ; Image-Guided Biopsy ; Middle Aged ; Predictive Value of Tests ; Preoperative Care/methods* ; Retrospective Studies ; Ultrasonography, Interventional* ; Ultrasonography, Mammary/methods*
Breast ; Core needle biopsy ; Shear-wave elastography ; Underestimation
OBJECTIVES: To determine whether lesion stiffness measured by shear-wave elastography (SWE) can be used to predict the histologic underestimation of ultrasound (US)-guided 14-gauge core needle biopsy (CNB) for breast masses. METHODS: This retrospective study enrolled 99 breast masses from 93 patients, including 40 high-risk lesions and 59 ductal carcinoma in situ (DCIS), which were diagnosed by US-guided 14-gauge CNB. SWE was performed for all breast masses to measure quantitative elasticity values before US-guided CNB. To identify the preoperative factors associated with histologic underestimation, patients' age, symptoms, lesion size, B-mode US findings, and quantitative SWE parameters were compared according to the histologic upgrade after surgery using the chi-square test, Fisher's exact test, or independent t-test. The independent factors for predicting histologic upgrade were evaluated using multivariate logistic regression analysis. RESULTS: The underestimation rate was 28.3% (28/99) in total, 25.0% (10/40) in high-risk lesions, and 30.5% (18/59) in DCIS. All elasticity values of the upgrade group were significantly higher than those of the non-upgrade group (P<0.001). On multivariate analysis, the mean (Odds ratio [OR]=1.021, P=0.001), maximum (OR=1.015, P=0.008), and minimum (OR=1.028, P=0.001) elasticity values were independently associated with histologic underestimation. The patients' age, lesion size, and final assessment category on US of the upgrade group were higher than those of the non-upgrade group (P=0.046 for age; P=0.021 for lesion size; P=0.030 for US category), but these were not independent predictors of histologic underestimation on multivariate analysis. CONCLUSION: Breast lesion stiffness quantitatively measured by SWE could be helpful to predict the underestimation of malignancy in US-guided 14-gauge CNB.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Jeong Ah(김정아) ORCID logo https://orcid.org/0000-0003-4949-4913
Park, Ah Young(박아영)
Son, Eun Ju(손은주) ORCID logo https://orcid.org/0000-0002-7895-0335
Youk, Ji Hyun(육지현) ORCID logo https://orcid.org/0000-0002-7787-780X
Han, Kyung Hwa(한경화)
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