Swe on breast cancer in dense breast with considerations on tnm staging
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Antonio Pio Masciotra Campobasso – Molise – Italy Email [email protected] Website www.masciotra.net YouTube Channel https://www.youtube.com/channel/UCgCj21nKGAhR997Ia3-QegQ Breast cancer in dense breast as seen at Shear Waves Elastography with discussion about the ‘T’ measurement in TNM staging
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This case shows how dense breast can hinder cancer at mammography and the important role of US and SWE elastography in situation like this. SWE could be the most reliable tool for the measurement of the 'T' parameter of TNM staging of breast cancer, especially if performed with 3D probe.
Transcript of Swe on breast cancer in dense breast with considerations on tnm staging
Antonio Pio MasciotraCampobasso – Molise – Italy
Website
www.masciotra.net
YouTube Channel
https://www.youtube.com/channel/UCgCj21nKGAhR997Ia3-QegQ
Breast cancer in dense breast as seenat Shear Waves Elastography
with discussion about the ‘T’ measurement in TNM staging
Woman 48 years old feeling a little painin upper quadrants of her right breast. Only mammography performed at the
first exam.
9 months later she feels a nodulebetween the upper quadrants of the
same breast.
27/08/2013
12/05/2014
27/08/2013 12/05/2014 27/08/2013 12/05/2014
Only right breast images in comparison are showed with closeup details.Very dense breast far to offerwell valuable signs.
Maybe the only differencesperceivable are in retromammaryfat area that in the second examseems to host ‘something new’at least in CC view (arrows).
Then US exam was performedshowed in next slides.
Woman 48 years old
Woman 48 years old
Feature (kPa) Nodule
Mean stiffness 86-118
Maximum stiffness 135-299
Minimum stiffness 0,1-95
Standard Deviation 9-64
Hypoechoic area 0,42 cm²
Stiffest area 1,17 cm²
The tumor area tracedaccording echogenicity is far smaller than the area traced
according the stiffness
Woman 48 years old
Feature Echogenicitybased data
Stiffnessbased data
Perimeter 5,42 cm 6,63 cm
Area 1,52 cm² 2,45 cm²
Diameter 1 1,48 cm 2,19
Diameter 2 1,45 cm 1,88
The tumor area traced according echogenicity is large smaller than the area traced according the stiffness.
Woman 48 years oldPlane Feature Echogenicitybased data
Stiffnessbased data
Difference(%)
CoronalPerimeter 5,89 cm 5,78 cm -1,87%
Area 1,47 cm² 2,06 cm² 40,1%
AxialPerimeter 3,03 cm 6,48 cm 80,9%
Area 0,47 cm² 1,35 cm² 187,2%
Sagittal Perimeter 4,06 cm 5,39 cm 32,8%
Area 0,69 cm² 1,71 cm² 147,8%
The tumor’s dimensions traced according echogenicity are always smaller than the ones traced according the stiffness in all planes.Breast cancer is staged by the TNM System : Tumor Size, node status, and metastasis. Tumor Size is divided into four classes based on the maximum diameter:
T-1 is from 0 to 2 centimeters.
T-2 is from 2 to 5 cm. T-3 is greater than 5 cm .T-4 is a tumor of any size that has broken through (ulcerated) the skin, or is attached to the chest wall.
So it would be wise to check which is the most reliable imaging technique of measurement of the ‘T’ parameterrelating it to the more accurate prognostic significance and to the right choice in the therapeutic approach.
T1mi Tumor ≤1 mm in greatest dimension.
T1a Tumor >1 mm but ≤5 mm in greatest dimension.
T1b Tumor >5 mm but ≤10 mm in greatest dimension.
T1c Tumor >10 mm but ≤20 mm in greatest dimension.
Antonio Pio MasciotraCampobasso – Molise – Italy
Website
www.masciotra.net
YouTube Channel
https://www.youtube.com/channel/UCgCj21nKGAhR997Ia3-QegQ
Breast cancer in dense breast as seenat Shear Waves Elastography
with discussion about the ‘T’ measurement in TNM staging
