Diagnostic value of mammography combined with ultrasound shear wave elastography and magnetic resonance imaging in breast cancer

Qi,Long-Xiu; Zhou,Xiao; Fu,Yi-Gang; Zhou,Wen-Yan

doi:10.3892/ol.2024.14831

Diagnostic value of mammography combined with ultrasound shear wave elastography and magnetic resonance imaging in breast cancer

Authors:
- Long-Xiu Qi
- Xiao Zhou
- Yi-Gang Fu
- Wen-Yan Zhou
View Affiliations

Affiliations: Department of Radiology, Yancheng No. 1 People's Hospital (The First People's Hospital of Yancheng), Affiliated Hospital of Medical School, Nanjing University, Yancheng, Jiangsu 224000, P.R. China, Department of Ultrasound, Yancheng No. 1 People's Hospital (The First People's Hospital of Yancheng), Affiliated Hospital of Medical School, Nanjing University, Yancheng, Jiangsu 224000, P.R. China
Published online on: December 3, 2024 https://doi.org/10.3892/ol.2024.14831
Article Number: 85
Copyright: © Qi et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Breast cancer is one of the most common malignancies affecting women worldwide, and an early diagnosis is critical for improving prognosis. The present study aimed to investigate the diagnostic value of mammography (MG) combined with ultrasound shear wave elastography (SWE) and magnetic resonance imaging (MRI) for the early screening of breast cancer. Patients with breast tumors who underwent lumpectomy at a single hospital between December 2021 and January 2023 were selected and categorized into a benign or malignant group based on pathological findings. All patients had undergone examinations with MG, SWE and MRI. Imaging parameters were subsequently compared between the two groups. A total of 93 patients with breast tumors were included in the study, comprising 37 individuals in the benign group and 56 in the malignant group. MG findings revealed that patients in the malignant group exhibited significantly higher incidences of high breast glandular density, irregular mass margins, unclear mass borders and axillary lymph node involvement compared with those in the benign group. SWE results indicated that the elasticity ratio of the lesion to fat, and the mean and maximum values of the elastic modulus were significantly lower in the benign group than in the malignant group. Additionally, MRI findings demonstrated that the MRI‑measured maximum diameter was larger, and the prevalence of irregular lesion morphology, irregular mass margins, signal enhancement and type III time‑signal intensity curves was greater in the malignant group compared with the benign group. The diagnostic sensitivity, specificity, positive predictive value and negative predictive value of MG + SWE + MRI were 94.6, 86.5, 91.4 and 91.4%, respectively. Furthermore, the diagnostic efficacy of this combination surpassed that of MG + SWE, MG + MRI and SWE + MRI (area under the curve, 0.906 vs. 0.767, 0.758 and 0.763, respectively). In conclusion, the combination of MG with SWE and MRI exhibits a superior performance in the early diagnosis of breast cancer, exhibiting higher diagnostic accuracy and reliability compared with pairwise combinations.

View Figures

View References

1	Kashyap D, Pal D, Sharma R, Garg VK, Goel N, Koundal D, Zaguia A, Koundal S and Belay A: Global increase in breast cancer incidence: risk factors and preventive measures. Biomed Res Int. 2022:96054392022. View Article : Google Scholar : PubMed/NCBI
2	World Health Organization, . Global breast cancer initiative implementation framework: Assessing, strengthening and scaling up of services for the early detection and management of breast cancer: Executive summary. World Health Organization; 2023
3	Zhu C, Chen M, Liu Y, Li P, Ye W, Ye H, Ye Y, Liu Z, Liang C and Liu C: Value of mammographic microcalcifications and MRI-enhanced lesions in the evaluation of residual disease after neoadjuvant therapy for breast cancer. Quant Imaging Med Surg. 13:5593–5604. 2023. View Article : Google Scholar : PubMed/NCBI
4	Bodewes FTH, van Asselt AA, Dorrius MD, Greuter MJW and de Bock GH: Mammographic breast density and the risk of breast cancer: A systematic review and meta-analysis. Breast. 66:62–68. 2022. View Article : Google Scholar : PubMed/NCBI
5	Qi J, Wang C, Ma Y, Wang J, Yang G, Wu Y, Wang H and Mi C: The potential role of combined shear wave elastography and superb microvascular imaging for early prediction the pathological response to neoadjuvant chemotherapy in breast cancer. Front Oncol. 13:11761412023. View Article : Google Scholar : PubMed/NCBI
6	Zhang L, Zhou XX, Liu L, Liu AY, Zhao WJ, Zhang HX, Zhu YM and Kuai ZX: Comparison of dynamic contrast-enhanced MRI and non-mono-exponential model-based diffusion-weighted imaging for the prediction of prognostic biomarkers and molecular subtypes of breast cancer based on radiomics. J Magn Reson Imaging. 58:1590–1602. 2023. View Article : Google Scholar : PubMed/NCBI
7	Mao YJ, Lim HJ, Ni M, Yan WH, Wong DW and Cheung JC: Breast tumour classification using ultrasound elastography with machine learning: A systematic scoping review. Cancers (Basel). 14:3672022. View Article : Google Scholar : PubMed/NCBI
8	Xu B, Hu X, Feng J, Geng C, Jin F, Li H, Li M, Li Q, Liao N, Liu D, et al: Chinese expert consensus on the clinical diagnosis and treatment of advanced breast cancer (2018). Cancer. 126:3867–3882. 2020. View Article : Google Scholar : PubMed/NCBI
9	Chinese Medical Association, . Mammography screening and diagnostic consensus. Chin J Radiol. 48:711–717. 2014.(In Chinese).
10	Arian A, Seyed-Kolbadi FZ, Yaghoobpoor S, Ghorani H, Saghazadeh A and Ghadimi DJ: Diagnostic accuracy of intravoxel incoherent motion (IVIM) and dynamic contrast-enhanced (DCE) MRI to differentiate benign from malignant breast lesions: A systematic review and meta-analysis. Eur J Radiol. 167:1110512023. View Article : Google Scholar : PubMed/NCBI
11	Lim YX, Lim ZL, Ho PJ and Li J: Breast cancer in asia: Incidence, mortality, early detection, mammography programs, and risk-based screening initiatives. Cancers (Basel). 14:42182022. View Article : Google Scholar : PubMed/NCBI
12	Shen Y, He J, Liu M, Hu J, Wan Y, Zhang T, Ding J, Dong J and Fu X: Diagnostic value of contrast-enhanced ultrasound and shear-wave elastography for small breast nodules. PeerJ. 12:e176772024. View Article : Google Scholar : PubMed/NCBI
13	Abdel Rahman RW, Refaie RMAE, Kamal RM, Lasheen SF and Elmesidy DS: The diagnostic accuracy of diffusion-weighted magnetic resonance imaging and shear wave elastography in comparison to dynamic contrast-enhanced MRI for diagnosing BIRADS 3 and 4 lesions. Egypt J Radiol Nucl Med. 52:1852021. View Article : Google Scholar
14	Asare B, White MJ and Rossi J: Metaplastic carcinoma with osteosarcomatous differentiation in the breast: Case report. Radiol Case Rep. 18:4272–4280. 2023. View Article : Google Scholar : PubMed/NCBI
15	Alaref A, Hassan A, Sharma Kandel R, Mishra R, Gautam J and Jahan N: Magnetic resonance imaging features in different types of invasive breast cancer: A systematic review of the literature. Cureus. 13:e138542021.PubMed/NCBI
16	Kubota K, Nakashima K, Nakashima K, Kataoka M, Inoue K, Goto M, Kanbayashi C, Hirokaga K, Yamaguchi K and Suzuki A: The Japanese breast cancer society clinical practice guidelines for breast cancer screening and diagnosis, 2022 edition. Breast Cancer. 31:157–164. 2024. View Article : Google Scholar : PubMed/NCBI
17	Yang H, Xu Y, Zhao Y, Yin J, Chen Z and Huang P: The role of tissue elasticity in the differential diagnosis of benign and malignant breast lesions using shear wave elastography. BMC Cancer. 20:9302020. View Article : Google Scholar : PubMed/NCBI
18	Jiang H, Yu X, Zhang L, Song L and Gao X: Diagnostic values of shear wave elastography and strain elastography for breast lesions. Rev Med Chil. 148:1239–1245. 2020. View Article : Google Scholar : PubMed/NCBI
19	Suvannarerg V, Chitchumnong P, Apiwat W, Lertdamrongdej L, Tretipwanit N, Pisarnturakit P, Sitthinamsuwan P, Thiravit S, Muangsomboon K and Korpraphong P: Diagnostic performance of qualitative and quantitative shear wave elastography in differentiating malignant from benign breast masses, and association with the histological prognostic factors. Quant Imaging Med Surg. 9:386–398. 2019. View Article : Google Scholar : PubMed/NCBI
20	Bian J, Zhang J and Hou X: Diagnostic accuracy of ultrasound shear wave elastography combined with superb microvascular imaging for breast tumors: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 100:e262622021. View Article : Google Scholar : PubMed/NCBI
21	Sravani N, Ramesh A, Sureshkumar S, Vijayakumar C, Abdulbasith KM, Balasubramanian G and Ch Toi P: Diagnostic role of shear wave elastography for differentiating benign and malignant breast masses. SA J Radiol. 24:19992020.PubMed/NCBI
22	Li J, Liu Y, Li Y, Li S, Wang J, Zhu Y and Lu H: Comparison of diagnostic potential of shear wave elastography between breast mass lesions and non-mass-like lesions. Eur J Radiol. 158:1106092023. View Article : Google Scholar : PubMed/NCBI
23	Xie L, Liu Z, Pei C, Liu X, Cui YY, He NA and Hu L: Convolutional neural network based on automatic segmentation of peritumoral shear-wave elastography images for predicting breast cancer. Front Oncol. 13:10996502023. View Article : Google Scholar : PubMed/NCBI
24	Shahzad R, Fatima I, Anjum T and Shahid A: Diagnostic value of strain elastography and shear wave elastography in differentiating benign and malignant breast lesions. Ann Saudi Med. 42:319–326. 2022. View Article : Google Scholar : PubMed/NCBI
25	Hadebe B, Harry L, Ebrahim T, Pillay V and Vorster M: The role of PET/CT in breast cancer. Diagnostics (Basel). 13:5972023. View Article : Google Scholar : PubMed/NCBI
26	Paydary K, Seraj SM, Zadeh MZ, Emamzadehfard S, Shamchi SP, Gholami S, Werner TJ and Alavi A: The evolving role of FDG-PET/CT in the diagnosis, staging, and treatment of breast cancer. Mol Imaging Biol. 21:1–10. 2019. View Article : Google Scholar : PubMed/NCBI
27	Hodgson R, Heywang-Köbrunner SH, Harvey SC, Edwards M, Shaikh J, Arber M and Glanville J: Systematic review of 3D mammography for breast cancer screening. Breast. 27:52–61. 2016. View Article : Google Scholar : PubMed/NCBI
28	Zhang M, Horvat JV, Bernard-Davila B, Marino MA, Leithner D, Ochoa-Albiztegui RE, Helbich TH, Morris EA, Thakur S and Pinker K: Multiparametric MRI model with dynamic contrast-enhanced and diffusion-weighted imaging enables breast cancer diagnosis with high accuracy. J Magn Reson Imaging. 49:864–874. 2019. View Article : Google Scholar : PubMed/NCBI
29	Yadav P, Harit S and Kumar D: Efficacy of high-resolution, 3-D diffusion-weighted imaging in the detection of breast cancer compared to dynamic contrast-enhanced magnetic resonance imaging. Pol J Radiol. 86:e277–e286. 2021. View Article : Google Scholar : PubMed/NCBI
30	Winkler J, Abisoye-Ogunniyan A, Metcalf KJ and Werb Z: Concepts of extracellular matrix remodelling in tumour progression and metastasis. Nat Commun. 11:51202020. View Article : Google Scholar : PubMed/NCBI
31	Majidpoor J and Mortezaee K: Angiogenesis as a hallmark of solid tumors-clinical perspectives. Cell Oncol (Dordr). 44:715–737. 2021. View Article : Google Scholar : PubMed/NCBI
32	Roy S, Kumaravel S, Sharma A, Duran CL, Bayless KJ and Chakraborty S: Hypoxic tumor microenvironment: Implications for cancer therapy. Exp Biol Med (Maywood). 245:1073–1086. 2020. View Article : Google Scholar : PubMed/NCBI