Utilization of lymph node elastography in the axillary staging of breast cancer
BackgroundThe differential diagnosis of lymphadenopathy is an important determinant of prognosis in patients with breast cancer (BC). Invasive, fine needle aspiration (FNA) biopsy has been long considered as the gold standard for differentiating malignant lymph nodes (LN) from benign ones. Ultrasono...
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Frontiers Media S.A.
2025-03-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1478701/full |
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| author | Marek Smolar Eva Kudelova Ivana Danova Vincent Lucansky Zuzana Dankova Diana Musova Marian Grendar Lenka Nosakova Peter Uhrik Marek Samec |
| author_facet | Marek Smolar Eva Kudelova Ivana Danova Vincent Lucansky Zuzana Dankova Diana Musova Marian Grendar Lenka Nosakova Peter Uhrik Marek Samec |
| author_sort | Marek Smolar |
| collection | DOAJ |
| description | BackgroundThe differential diagnosis of lymphadenopathy is an important determinant of prognosis in patients with breast cancer (BC). Invasive, fine needle aspiration (FNA) biopsy has been long considered as the gold standard for differentiating malignant lymph nodes (LN) from benign ones. Ultrasonography (USG) evaluation is a useful, rapid, and user-friendly imaging tool for LN assessment due to its high resolution. Compared to USG, ultrasound elastography is a relatively novel non-invasive method to differentiate benign and malignant lesions based on the stiffness heterogeneity of the tissue. The purpose of our study was to compare non-invasive imaging techniques, conventional USG, and strain elastography, to differentiate benign and malignant LNs lesions in a cohort of patients with early BC.MethodsIn total, 50 patients (48 women and 2 men) with histologically confirmed early BC were evaluated by conventional USG in B-mode followed by strain elastography (using parameters: pattern, strain ratio, hue histogram) for assessment of axillary LNs status. The surgical treatment included surgery of regional LNs (sentinel LN biopsy or axillary dissection), which served as the gold standard in statistical processing.ResultsThe USG B-mode was found to have a sensitivity of 68.75% and a specificity of 61.54%. Among strain elastography parameters, the elastographic pattern showed the highest specificity (66.67%) while the sensitivity was 83.3%. The strain ratio showed 100% sensitivity and 55.6% specificity, followed by a hue histogram with a sensitivity of 72.2%, but specificity was only 25.9%.ConclusionDespite promising data, monitored parameters currently cannot reliably replace sentinel LN biopsy. However, the monitored parameters represent an appropriate additional tool that can be used to refine preoperative staging, better targeting of FNA biopsy, and more accurate assessment of LNs in follow-up patients within the dispensary. |
| format | Article |
| id | doaj-art-e8ed8b8bb30a4f84bf83136ffaf35186 |
| institution | DOAJ |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-e8ed8b8bb30a4f84bf83136ffaf351862025-08-20T02:59:23ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-03-011510.3389/fonc.2025.14787011478701Utilization of lymph node elastography in the axillary staging of breast cancerMarek Smolar0Eva Kudelova1Ivana Danova2Vincent Lucansky3Zuzana Dankova4Diana Musova5Marian Grendar6Lenka Nosakova7Peter Uhrik8Marek Samec9Clinic of General, Visceral and Transplant Surgery, Jessenius Faculty of Medicine, Comenius University in Bratislava, University Hospital Martin, Martin, SlovakiaClinic of General, Visceral and Transplant Surgery, Jessenius Faculty of Medicine, Comenius University in Bratislava, University Hospital Martin, Martin, SlovakiaClinic of General, Visceral and Transplant Surgery, Jessenius Faculty of Medicine, Comenius University in Bratislava, University Hospital Martin, Martin, SlovakiaDepartment of Pathological Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, SlovakiaBiobank for Cancer and Rare Diseases, Jessenius Faculty of Medicine in Martin (JFMED CU), Comenius University in Bratislava, Martin, SlovakiaClinic of General, Visceral and Transplant Surgery, Jessenius Faculty of Medicine, Comenius University in Bratislava, University Hospital Martin, Martin, SlovakiaBiomedical Centre Martin, Jessenius Faculty of Medicine in Martin (JFMED CU), Comenius University in Bratislava, Martin, SlovakiaClinic of Gastroenterological Internal Medicine, Jessenius Faculty of Medicine, Comenius University in Bratislava, University Hospital, Martin, SlovakiaClinic of Gastroenterological Internal Medicine, Jessenius Faculty of Medicine, Comenius University in Bratislava, University Hospital, Martin, SlovakiaDepartment of Medical Biology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, SlovakiaBackgroundThe differential diagnosis of lymphadenopathy is an important determinant of prognosis in patients with breast cancer (BC). Invasive, fine needle aspiration (FNA) biopsy has been long considered as the gold standard for differentiating malignant lymph nodes (LN) from benign ones. Ultrasonography (USG) evaluation is a useful, rapid, and user-friendly imaging tool for LN assessment due to its high resolution. Compared to USG, ultrasound elastography is a relatively novel non-invasive method to differentiate benign and malignant lesions based on the stiffness heterogeneity of the tissue. The purpose of our study was to compare non-invasive imaging techniques, conventional USG, and strain elastography, to differentiate benign and malignant LNs lesions in a cohort of patients with early BC.MethodsIn total, 50 patients (48 women and 2 men) with histologically confirmed early BC were evaluated by conventional USG in B-mode followed by strain elastography (using parameters: pattern, strain ratio, hue histogram) for assessment of axillary LNs status. The surgical treatment included surgery of regional LNs (sentinel LN biopsy or axillary dissection), which served as the gold standard in statistical processing.ResultsThe USG B-mode was found to have a sensitivity of 68.75% and a specificity of 61.54%. Among strain elastography parameters, the elastographic pattern showed the highest specificity (66.67%) while the sensitivity was 83.3%. The strain ratio showed 100% sensitivity and 55.6% specificity, followed by a hue histogram with a sensitivity of 72.2%, but specificity was only 25.9%.ConclusionDespite promising data, monitored parameters currently cannot reliably replace sentinel LN biopsy. However, the monitored parameters represent an appropriate additional tool that can be used to refine preoperative staging, better targeting of FNA biopsy, and more accurate assessment of LNs in follow-up patients within the dispensary.https://www.frontiersin.org/articles/10.3389/fonc.2025.1478701/fullelastographybreast cancerlymph nodeultrasonographymetastasisimaging techniques |
| spellingShingle | Marek Smolar Eva Kudelova Ivana Danova Vincent Lucansky Zuzana Dankova Diana Musova Marian Grendar Lenka Nosakova Peter Uhrik Marek Samec Utilization of lymph node elastography in the axillary staging of breast cancer Frontiers in Oncology elastography breast cancer lymph node ultrasonography metastasis imaging techniques |
| title | Utilization of lymph node elastography in the axillary staging of breast cancer |
| title_full | Utilization of lymph node elastography in the axillary staging of breast cancer |
| title_fullStr | Utilization of lymph node elastography in the axillary staging of breast cancer |
| title_full_unstemmed | Utilization of lymph node elastography in the axillary staging of breast cancer |
| title_short | Utilization of lymph node elastography in the axillary staging of breast cancer |
| title_sort | utilization of lymph node elastography in the axillary staging of breast cancer |
| topic | elastography breast cancer lymph node ultrasonography metastasis imaging techniques |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1478701/full |
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