title: Prediction of invasive breast cancer using shear-wave elastography in patients with biopsy-confirmed ductal carcinoma in situ.
abstract: OBJECTIVE
  To investigate whether mass stiffness measured by shear-wave elastography (SWE) can predict the histological upgrade of ductal carcinoma in situ (DCIS) confirmed through ultrasound (US)-guided core needle biopsy (CNB).
  
  
  METHODS
  The institutional review board approved this study and informed consent was waived. A database search revealed 120 biopsy-confirmed DCIS in patients who underwent B-mode US and SWE prior to surgery. Clinicopathologic results, B-mode findings, size on US, and mean and maximum elasticity values on SWE were recorded. Associations between upgrade to invasive cancer and B-mode US findings, SWE information, and clinical variables were assessed using univariate, multivariate logistic regression, and multiple linear regression analysis.
  
  
  RESULTS
  The overall upgrade rate was 41.7 % (50/120). Mean stiffness value (P = .014) and mass size (P = .001) were significantly correlated with histological upgrade. The optimal cut-off value of mean stiffness value, yielding the maximal sum of sensitivity and specificity, was 70.7 kPa showing sensitivity of 72 % and specificity of 65.7 % for detecting invasiveness. Qualitative elasticity colour scores were significantly correlated with the histological upgrade, mammographic density, and B-mode category (P < .04).
  
  
  CONCLUSIONS
  Mean stiffness values evaluated through SWE can be utilized as a preoperative predictor of histological upgrade to invasive cancer in DCIS confirmed at US-guided needle biopsy.
  
  
  CONCLUSIONS
  • Higher stiffness values were noted in invasive cancer than DCIS. • Qualitative SWE colour scores significantly correlated with the histological upgrade. • Qualitative SWE colour scores had excellent interobserver agreement.
authors.affiliation: Department of Radiology, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.
authors.forename: Jae Seok
authors.initials: JS
authors.lastname: Bae
authors.affiliation: Department of Radiology, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 110-744, Korea. imchangjm@gmail.com.
authors.forename: Jung Min
authors.initials: JM
authors.lastname: Chang
authors.affiliation: Department of Radiology, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.
authors.forename: Su Hyun
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Radiology, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.
authors.forename: Sung Ui
authors.initials: SU
authors.lastname: Shin
authors.affiliation: Department of Radiology, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.
authors.forename: Woo Kyung
authors.initials: WK
authors.lastname: Moon
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis*; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis*; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008875:Middle Aged; D011237:Predictive Value of Tests; D016217:Ultrasonography, Mammary / Q000379:methods*
keywords: Breast Neoplasms; Carcinoma, Ductal, Breast; Carcinoma, Intraductal, Noninfiltrating; Elasticity Imaging Techniques; Ultrasound