Ultrasound and Shear Wave Elastography for Distinguishing Benign and Malignant Axillary Lymph Nodes in Breast Cancer Patients

Abstract

This study aimed to assess the diagnostic efficacy of ultrasound (US) and shear wave elastography (SWE) in distinguishing benign and malignant axillary lymph nodes in patients with breast cancer. A total of 121 axillary lymph nodes from 61 breast cancer patients (mean age, 52.4 +/- 14.6 years) were enrolled between May 2019 and August 2020. Lymph nodes were histopathologically diagnosed through core needle biopsy or surgical excision. B-mode US features (short axis diameter, short-to-long axis diameter ratio, presence of echogenic hilum, presence of asymmetric cortical thickening, cortex thickness) were assessed and SWE measurements (maximum shear wave velocity (SWVmax), minimum SWV (SWVmin), median SWV (SWVmedian), mean SWV (SWVmean)) were performed. There were 45 (37.2%) benign and 76 (62.8%) malignant lymph nodes. The short axis diameter, short-to-long axis diameter ratio, and mean cortical thickness of malignant lymph nodes were significantly higher compared to benign lymph nodes (p<0.001 all). SWVmean, SWVmedian, SWVmax, and SWVmin of malignant lymph nodes were significantly higher than those of benign lymph nodes (p<0.001 for all). Both US and SWE were useful in discriminating between benign and malignant axillary lymph nodes.