Contrast enhancement spectral mammography combined with pathological parameters for diagnosing axillary lymph node metastases of breast cancer

Abstract

Objective To explore the value of contrast enhancement spectral mammography (CESM) combined with pathological parameters for diagnosing axillary lymph node (ALN) metastases of breast cancer. Methods Totally 215 patients with mass type breast cancer were enrolled and randomly divided into training set (n= 155) and validation set (n= 60) at the ratio of 18:7. CESM characteristics and pathological parameters of breast masses with or without ALN metastases in training set were compared, then logistic regression analysis was performed. The independent risk factors of ALN metastases of breast cancer were screened to establish a model,and the value of the model for diagnosing ALN metastases was analyzed. Results In the training set,significant differences of quadrant, maximum diameter,shape, margin spiculation sign, preaxillary enlarged lymph nodes, the relative enhancement rate of lesion over background on cranio caudal (CC,RS%CC) or medial lateral oblique (MLO,RS%MLO) view,histological type, lymphovascular invasion and Ki-67 expression were found between breast masses with or without ALN metastases (all P<0. 05). The maximum diameter, margin spiculation sign, preaxillary enlarged lymph nodes, RS%MLO» lymphovascular invasion and Ki-67 expression were all independent risk factors of ALN metastases (all P