Background:The pretherapeutic assessment of axillary lymph node status is crucial in staging early breast cancer patients, significantly influencing their further treatment and prognosis. According to current guidelines, patients with clinically unsuspicious axillary status regularly undergo a biopsy of sentinel lymph nodes (SLNs), whereby metastasis is detected in up to 20% of cases. In recent years, the use of shear wave elastography (SWE) has been studied as an additional ultrasound tool for the non-invasive assessment of tumors in the breast parenchyma and axillary lymph nodes. Previous studies (examining the axilla in patients) have shown that metastases have significantly higher SWE values than benign nodes.Methods:This study aims to evaluate whether SWE can differentiate between tumor-free and metastatic-affected SLN ex vivo, i.e., by examining the pathological specimen. SWE was performed ex vivo on SLN specimens and compared with final histopathological results.Results:A total of 168 SLNs from 105 patients were measured using ex vivo SWE and subjected to standard histopathological processing. In this group, 17 metastases in 17 patients (16.19%) were detected. Tumor-free SLNs had a mean velocity of 1.33 ± 0.23 m/s, while metastatic nodes showed a mean velocity of 1.35 ± 0.29 m/s (p= 0.724). There was no significant difference in ex vivo SWE between benign and malignant SLNs in this population.Conclusions:Contrary to previous studies, this study did not find SWE effective in differentiating lymph node metastases. Further research is needed to clarify SWE’s potential role in axillary staging.
背景：术前评估腋窝淋巴结状态对早期乳腺癌患者的分期至关重要，显著影响其后续治疗及预后。根据现行指南，临床腋窝状态无异常的患者常规接受前哨淋巴结活检，其中高达20%的病例可检测到转移灶。近年来，剪切波弹性成像作为一种辅助超声工具，已被研究用于乳腺实质及腋窝淋巴结肿瘤的无创评估。既往研究（针对患者腋窝区域）显示，转移性淋巴结的SWE值显著高于良性淋巴结。 方法：本研究旨在评估SWE能否在离体条件下（即通过对病理标本的检测）区分无肿瘤转移与存在转移的前哨淋巴结。研究对前哨淋巴结标本进行离体SWE检测，并与最终组织病理学结果进行对比分析。 结果：共对105例患者的168枚前哨淋巴结进行离体SWE测量及标准组织病理学处理。该队列中，17例患者（16.19%）检出17处转移灶。无肿瘤转移的前哨淋巴结平均传播速度为1.33±0.23 m/s，而转移性淋巴结平均传播速度为1.35±0.29 m/s（p=0.724）。在该研究人群中，良恶性前哨淋巴结的离体SWE检测结果无显著差异。 结论：与既往研究结论不同，本研究发现SWE在鉴别淋巴结转移方面未显示有效性。需进一步研究以明确SWE在腋窝分期中的潜在作用。
肿瘤(癌症)患者之家