Journal
JOURNAL OF ULTRASOUND IN MEDICINE
Volume 39, Issue 10, Pages 2059-2070Publisher
WILEY
DOI: 10.1002/jum.15314
Keywords
axillary lymph node metastasis; breast invasive ductal carcinoma; contrast-enhanced ultrasound; conventional ultrasound
Funding
- National Natural Science Foundation of China [81927801, 81725008]
- Fundamental Research Funds for the Central Universities [22120190213]
- Shanghai Municipal Health Commission [2019LJ21, SHSLCZDZK03502]
- Science and Technology Commission of Shanghai Municipality [19441903200, 19DZ2251100]
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Objectives The purpose of this study was to establish a scoring system for predicting axillary lymph node metastasis (ALNM) in patients with breast invasive ductal carcinoma with negative axillary ultrasound (US) results. Methods In this retrospective study, 156 breast invasive ductal carcinoma lesions from 156 women were retrospectively enrolled. The features of conventional US and contrast-enhanced ultrasound (CEUS) qualitative enhancement patterns and quantitative enhancement parameters were analyzed. Subsequently, a scoring system was created by a multivariate logistic regression analysis. Results The results found that 60 patients (38%) showed ALNM. A scoring system was defined as risk score = 1.75 x (if lesion size >= 20 mm) + 1.93 x (if uncircumscribed margin shown on conventional US) + 1.77 x (if coarse or twisting penetrating vessels shown on CEUS). When the risk scores were less than 1.75, 1.75 to 1.93, 1.94 to 3.70, and 3.70 or higher, the risk rates of ALNM were 0% (0 of 9), 10.7% (5 of 46), 29.2% (14 of 48) and 77.4% (41 of 53), respectively. In comparison with conventional US alone, the scoring system using the combination of conventional US and CEUS showed better discrimination ability in terms of the area under the curve (0.830 versus 0.777; P = .037). Conclusions A scoring system based on conventional US and CEUS may improve the prediction of ALNM.
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