| ObjectiveBy applying ultrasound elastography（UE）technology to examine the lesions of breast cancer patients and the breast cancer patients receiving neoadjuvant chemotherapy（NAC）,the paper explores the clinical application value of UE in the diagnosis of breast cancer and the evaluation of the efficacy of NAC.Methods1.Ultrasonography,two-dimensional shear wave elastography（2D-SWE）and three-dimensional shear wave elastography（3D-SWE）were performed on 234 lesions of 214 patients with breast masses confirmed by surgical pathology.The quantitative parameters were obtained by Q-Boxtm.Receiver operating characteristic（ROC）curves were used to analyze the diagnostic efficacy of SWE parameters in the differential diagnosis of benign and malignant breast lesions,and Mc Nemar test was used for the comparison of sensitivity and specificity.2.Ultrasonography,2D-SWE and 3D-SWE were performed on 125patients with invasive ductal carcinoma of the breast,and relevant clinicopathological and immunohistochemical indicators were recorded.The correlation between the quantitative parameters of 2D-SWE and3D-SWE and the prognostic factors of invasive breast cancer was investigated by univariate analysis and multivariate linear regression.3.Ultrasonography and Strain Elastography（SE）were performed on40 breast cancer patients receiving NAC in the week before,the week after the second cycle of chemotherapy,and the week after the fourth cycle of chemotherapy and before surgery,respectively.Routine ultrasound and SWE were performed on 21 breast cancer patients receiving NAC in 20cases.The diagnostic efficacy of NAC efficacy was evaluated by ROC curve analysis of SE and SWE.Results1.The difference in Emax,Emean-w,SD,Emean-h and Eratio of the lesion with surrounding adipose tissue in the three orthogonal planes of2D-SWE and 3D-SWE was statistically significant（P<0.005）.Emean-w showed low diagnostic efficiency（P<0.005）.2.Single-factor analysis showed that tumor size and pathological grade were significantly positively correlated with Emax and Emean of 2D-SWE and 3D-SWE in invasive ductal carcinoma（P<0.05）,and lymph node metastasis was significantly positively correlated with Emax and Emean of 3D-SWE（P<0.05）.ER expression was negatively correlated with Emax and Emean of 2D-SWE,Her2 was positively correlated with Emax and Emean of 3D-SWE,and Ki67 was positively correlated with Emax and Emean of 2D-SWE and 3D-SWE.Luminal A breast cancer has low hardness.Multiple linear regression results showed that tumor size and pathological grading were independently correlated with SWE quantitative parameters,while ER,PR,Her2 expression,Ki67 expression and molecular subtype were not significantly correlated.3.Efficacy of NAC can be evaluated by SE scoring method after the second and fourth cycles of NAC.Efficacy of NAC can be evaluated after the second and fourth cycles of NAC by SE semi-quantitative method with normal breast tissue as reference and adipose tissue as reference.The efficacy of NAC was assessed by SWE quantitative parameters after the second and fourth cycles of NAC,with no statistically significant difference in diagnostic efficacy（P>0.05）and no statistically significant difference between SWE quantitative parameters and SE semi-quantitative methods（P>0.05）.Conclusion1.Both 2D-SWE and 3D-SWE can quantitatively diagnose the benign and malignant breast masses.2.Both 2D-SWE and 3D-SWE parameters were significantly independent of the clinicopathological characteristics of invasive ductal carcinoma of the breast,including tumor diameter and histopathological grade,but not independent of the immunohistochemical factors and molecular subtypes of invasive ductal carcinoma.3.Both SE and SWE imaging can be used to evaluate the efficacy of NAC in breast cancer,and the difference in diagnostic efficacy between the two is not statistically significant.Both can be used to evaluate the efficacy of NAC. |
