Correlation of Sonographic Features with Prognostic Factors in Ductal Carcinoma In Situ: An Exploratory Study Using Ultrasound and Shear Wave Elastography

Objective: To investigate the correlation between sonographic features obtained from conventional ultrasound (Con-US) and shear wave elastography (SWE) with pathological prognostic factors in ductal carcinoma in situ (DCIS), and to evaluate the efficacy of combining these two modalities in predicting DCIS prognosis. Methods A retrospective analysis was conducted on clinical data, Con-US, and SWE imaging features of 83 DCIS patients who underwent surgical resection between June 2018 and December 2022. Binary logistic regression analysis was performed to explore the relationship between sonogram indices and pathological prognostic factors. Results The results revealed that microcalcification observed on Con-US was an independent risk factor for high-grade DCIS and comedonecrosis (odds ratio (OR) = 5.316 and 4.512). In SWE images, the Emax value was significantly different between the non-high-grade and high-grade DCIS groups (P = 0.006), with an Emax value greater than 75.03 kPa identified as an independent risk factor for high-grade DCIS (OR = 1.022 and the area under the curve (AUC) 0.682, 95% confidence interval (CI) 0.555–0.808). Additionally, the Ecolor, Emax, Emean, and EmeanSD values were statistically different between the groups with and without comedonecrosis (P = 0.049, 0.006, 0.012, 0.022), with an Emean value exceeding 30.45 kPa identified as an independent risk factor for comedonecrosis (OR = 1.025, and the AUC 0.708, 95% CI 0.562–0.854). Furthermore, combining microcalcification on Con-US with specific SWE indicators demonstrated an improved predictive specificity for high-grade DCIS and comedonecrosis (results were 0.902 and 0.889, respectively). No significant difference was found in other indexes on SWE. Conclusions These findings suggest that integrating Con-US and SWE modalities can enhance the predictive performance of DCIS prognosis assessment.