Evaluation And Correlation Of Preoperative Multimodal Ultrasound Characteristics And Postoperative Recurrence Risk Of Breast Cancer

Background and purpose: At present,as the most common malignant tumor among women in China,the incidence rate of breast cancer is increasing year by year,which seriously threatens women’s physical and mental health.Patients may face the risk of recurrence or metastasis even if they receive standard systematic treatment.Accurate assessment of the recurrence risk of breast cancer is of great significance for the formulation of postoperative adjuvant systemic treatment.Ultrasonography is a commonly used imaging method for breast diseases,in which two-dimensional,color Doppler imaging,elastic imaging and other multimodal ultrasound can provide a large amount of diagnostic information.This study intends to screen out key ultrasound features related to the recurrence risk of breast cancer,and screen out independent predictors of postoperative recurrence risk,and then establish a recurrence risk assessment model to guide the formulation of treatment plans for breast cancer patients.Methods: A retrospective analysis was made of 400 female patients with breast cancer who were admitted to the Second Affiliated Hospital of Harbin Medical University and the Cancer Hospital of Harbin Medical University from 2018 to 2019 and were confirmed by pathology.Complete and clear two-dimensional ultrasound images,color Doppler flow imaging(CDFI)and elastic images were collected before surgery,and complete clinical and pathological data were also collected.All patients were randomly selected 80% as the training set,and the remaining 20%as the test set.According to the evaluation criteria in the Guidelines and Specifications for Diagnosis and Treatment of breast cancer of the Chinese Anti Cancer Association,the training set was divided into high risk group and low-medium risk group.And the differences of their preoperative multimodal ultrasound characteristics between the two groups were analyzed to screen out independent predictors that affect the postoperative recurrence risk of breast cancer.And a nomograph model was established.The training set and the test set were used to verify the model internally and externally to evaluate the prediction ability of the model.Results:(1)There was no statistical difference between training set and test set in ultrasound characteristics(P>0.05).(2)In the high risk group and low-medium risk group of the training set,there were statistically significant differences in tumor size,boundary,posterior echo,hyperechoic halo,internal echo,BI-RADS grade,blood flow grade and elasticity score(P<0.05).(3)In multivariate logistic regression analysis,the size,boundary,hyperechoic halo,internal echo,blood flow grade and elasticity score of the lesions were selected as independent predictors of high recurrence risk.(4)The nomograph model was established by using independent prediction factors.The Cindex of internal verification and external verification were 0.848 and 0.863,respectively.The model had good prediction ability.Conclusion: The size,boundary,hyperechoic halo,internal echo,blood flow grade and elasticity score of breast lesions were independent predictors of high recurrence risk of breast cancer.The nomogram model based on the above ultrasound features can better predict the risk of recurrence,and provide important imaging information for clinical preoperative treatment.