Quantitative ultrasound as a predictor of node metastases and prognosis in patients with breast cancer

被引：18

作者：

Hashimoto H. ^{[1
]}

Suzuki M. ^{[1
]}

Oshida M. ^{[1
]}

Nagashima T. ^{[1
]}

Yagata H. ^{[1
]}

Shishikura T. ^{[1
]}

Imanaka N. ^{[1
]}

Nakajima N. ^{[1
]}

机构：

[1] First Department of Surgery, Chiba University School of Medicine

来源：

Breast Cancer | 2000年 / 7卷 / 3期

关键词：

Breast carcinoma; Metastasis; Prognosis; Quantitative analysis; Ultrasonography;

D O I：

10.1007/BF02967467

中图分类号：

学科分类号：

摘要：

Background: A retrospective study was performed to determine whether preoperative quantitative ultrasound assessment could predict axillary lymph node metastases and prognosis in patients with breast cancer. We focused on the presence of a halo, which is one of the features of breast cancer on ultrasound and represents reflections from the invading margin around infiltrating malignancies. Methods: We evaluated ultrasonography from 187 infiltrating breast carcinoma patients with tumors 5 cm or less in greatest dimension (T1, T2). Using computer image analysis, the halo area (H) and the sum of the area of halo and internal echo (total tumor area (T)) were measured, and the ratio of halo to entire tumor (H/T, halo ratio) was calculated and compared with lymph node status and prognosis. Results: The mean of the halo ratio was 0.38-±-0.13. Using the value of 0.42 as a cut-off, the high halo ratio group had significantly worse prognoses for both overall and disease-free survival at 49 months in median follow-up (p<O.001 and p<0.0005, respectively). The specificity of a high halo ratio in the T1 classification for predicting axillary node metastasis was 83.1%, with a negative predictive value of 86.8%. In patients with tumors 1.0 cm or smaller, the negative predictive value was 100%. In a multivariate analysis, halo ratio was an independent predictor of disease-free survival of breast carcinoma patients (p=0.0232). Conclusions: Preoperative quantitative ultrasound may be a useful non-invasive method for predicting the presence of axillary lymph node metastases and prognosis in patients with primary breast cancer.

引用

页码：241 / 246

页数：5

共 36 条

[1]

Mendelson E.B., Tobin C.E., The breast, Ultrasonography, pp. 377-397, (1996)

[2]

Svensson W.E., A review of the current status of breast ultrasound, European Journal of Ultrasound, 6, 2, pp. 77-101, (1997)

[3]

Fisher B., Bryant J., Wolmark N., Mamounas E., Brown A., Fisher E.R., Wickerham D.L., Begovic M., DeCillis A., Robidoux A., Margolese R.G., Cruz A.B., Hoehn J.L., Lees A.W., Dimitrov N.V., Bear H.D., Effect of preoperative chemotherapy on the outcome of women with operable breast cancer, Journal of Clinical Oncology, 16, 8, pp. 2672-2685, (1998)

[4]

Silverstein M.J., Gierson E.D., Waisman J.R., Senofsky G.M., Colburn W.J., Gamagami P., Axillary lymph node dissection for T1a breast carcinoma: Is it indicated?, Cancer, 73, 3, pp. 664-667, (1994)

[5]

Kuznetsova M., Graybill J.C., Zusag T.W., Et al., Omission of axillary lymph node dissection in early-stage breast cancer: Effect on treatment outcome, Radiology, 197, pp. 507-510, (1995)

[6]

Wazer D.E., Erban J.K., Robert N.J., Smith T.J., Marchant D.J., Schmid C., DiPetrillo T., Schmidt-Ullrich R., Breast conservation in elderly women for clinically negative axillary lymph nodes without axillary dissection, Cancer, 74, pp. 878-883, (1994)

[7]

Giuliano A.E., Kirgan D.M., Guenther J.M., Morton D.L., Lymphatic mapping and sentinel lymphadenectomy for breast cancer, Annals of Surgery, 220, 3, pp. 391-401, (1994)

[8]

Giuliano A.E., Dale P.S., Turner R.R., Et al., Improved axillary staging of breast cancer with sentinel lymphadenectomy, Ann Surg, 222, pp. 394-401, (1995)

[9]

Tohno E., Cosgrove D.O., Sloane J.P., Ultrasound Diagnosis of Breast Diseases, (1994)

[10]

Cole Beuglet C., Soriano R.Z., Kurtz A.B., Goldberg B.B., Ultrasound analysis of 104 primary breast carcinomas classified according to histopathologic type, Radiology, 147, 1, pp. 191-196, (1983)

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