The Value of Nomograms in Pre-Operative Prediction of Lymphovascular Invasion in Primary Breast Cancer Undergoing Modified Radical Surgery: Based on Multiparametric Ultrasound and Clinicopathologic Indicators

Preoperative prediction of lymphovascular invasion in patients with T1 breast invasive ductal carcinoma based on radiomics nomogram using grayscale ultrasound

“…The clearest and most complete US images were obtained in DICOM format. The following conventional ultrasound (CUS) features of breast tumors were recorded in concordance with prior studies (12,18) (8) tumor posterior features: no posterior acoustic features, enhancement, shadowing or combined pattern. In addition, suspicious CUS features of axillary lymph node metastasis (LNM) were also evaluated, including rounded hypoechoic node complete or partial effacement of the fatty hilum, the ratio of long axis diameter to short axis diameter < 2, cortical thickening > 3 mm, nonhilar cortical blood flow on color Doppler images, complete or partial replacement of the node with an ill-defined or irregular mass and microcalcifications in the node (25).…”

“…Previous studies (6)(7)(8)(9) had also demonstrated that the presence of LVI was closely associated with axillary lymph node involvement, which were consistent with our study. Similarly, ZHOU et al (12) and Tong et al (8) all thought that suspicious findings on axillary US imaging were independent predictor for the presence of LVI. Moreover, LVI-positive were more likely to have nodal metastases than LVI-negative in T1 breast cancer patients (9), whereas lymph node metastases were naturally relatively low in T1 breast cancer (35), perhaps more likely to be LVI-positive at the time of lymph node metases.…”

“…LVI was highlighted as a risk factor with important implications for survival in patients with T1 breast cancer (9,10). The presence of LVI is not always able to be detected at biopsy, owing to the small tissue volume to be cut and obtained from the primary tumor (3,12,13); therefore, noninvasive prediction of LVI is necessary. Previously, it had been demonstrated that the clinic_CUS features of breast carcinoma could distinguish LVI-positive from LVI-negative (8,12).…”

“…The presence of LVI is not always able to be detected at biopsy, owing to the small tissue volume to be cut and obtained from the primary tumor (3,12,13); therefore, noninvasive prediction of LVI is necessary. Previously, it had been demonstrated that the clinic_CUS features of breast carcinoma could distinguish LVI-positive from LVI-negative (8,12). In our study, tumor margin and US_LNM status were independent predictors of LVI in the clinic_CUS model.…”

“…Currently, the presence of LVI is determined by postoperative pathology based on the primary tumor and peritumoral breast tissue ( 12 , 13 ). However, several factors, such as partial sampling of tumors in preoperative biopsies, contractility of materials, and mechanical force-induced cell displacement, may complicate the postoperative assessment of LVI and lead to misdiagnosis ( 3 , 14 ).…”