Not all nodes are alike: shear wave elastography in differentiating metastatic and non-metastatic axillary lymph nodes in breast cancer

Aims: Accurate assessment of axillary lymph node (ALN) status in breast cancer is critical for staging and surgical planning. Owing to the limitations of conventional ultrasound (US), the diagnostic accuracy of shear wave elastography (SWE), which can quantitatively measure tissue stiffness, was investigated. Methods: This retrospective study included 150 patients with histopathologically confirmed primary breast cancer. A total of 210 ALNs were examined preoperatively using US and SWE. SWE measurements were performed using shear wave velocity (SWV) and elasticity modulus parameters. Histopathological results were considered to be the gold standard. The sensitivity, specificity, and AUC (area under the curve) values were calculated using ROC (receiver operating characteristic) analysis. Results: SWV (4.12±0.88 m/s) and elasticity modulus (50.4±8.9 kPa) were significantly higher in metastatic nodes (p