Abstract
ObjectiveTo explore the feasibility of shear wave elastography (SWE) parameters for assessing the biological behavior of breast cancer.Materials and MethodsIn this prospective study, 224 breast cancer lesions in 216 female patients were examined by B-mode ultrasound and shear wave elastography in sequence. The maximum size (Smax) of the lesion was measured by B-mode ultrasound, and then shear wave elastography was performed on this section to obtain relevant parameters, including maximum elasticity (Emax), mean elasticity (Emean), standard deviation of elasticity (SD), and the area ratio of shear wave elastography to B-mode ultrasound (AR). The relationship between SWE parameters and pathological type, histopathological classification, histological grade, lymphovascular invasion status (LVI), axillary lymph node status (ALN), and immunohistochemistry of breast cancer lesions was performed according to postoperative pathology.ResultsIn the univariate analysis, the pathological type and histopathological classification of breast cancer were not significantly associated with SWE parameters; with an increase in the histological grade of invasive ductal carcinoma (IDC), SD (p = 0.016) and Smax (p = 0.000) values increased. In the ALN-positive group, Smax (p = 0.004) was significantly greater than in the ALN-negative group; Smax (p = 0.003), Emax (p = 0.034), and SD (p = 0.045) were significantly higher in the LVI-positive group than in the LVI-negative group; SD (p = 0.043, p = 0.047) and Smax (p = 0.000, p = 0.000) were significantly lower in the ER+ and PR+ groups than in the ER- and PR- groups, respectively; AR (p = 0.032) was significantly higher in the ER+ groups than in the ER- groups, and Smax (p = 0.002) of the HER2+ group showed higher values than that of the HER2- group; Smax (p = 0.000), SD (p = 0.006), and Emax (p = 0.004) of the Ki-67 high-expression group showed significantly higher values than those of the Ki-67 low-expression group. In the multivariate analysis, Ki-67 was an independent factor of Smax (p = 0.005), Emax (p = 0.004), and SD (p = 0.006); ER was an independent influencing factor of Smax (p = 0.000) and AR (p = 0.032). LVI independently influences Smax (p = 0.006).ConclusionsThe SWE parameters Emax, SD, and AR can be used to evaluate the biological behavior of breast cancer.
Highlights
Breast cancer is one of the most common cancers, and the mortality rate of breast cancer ranks first among women [1]
The Shear wave elastography (SWE) parameters Emax, standard deviation of elasticity (SD), and AR can be used to evaluate the biological behavior of breast cancer
The pathological type, histopathological classification, histological grade, axillary lymph node status (ALN), lymphovascular invasion status (LVI), and immunohistochemical factors such as estrogen receptor (ER) and progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and the Ki-67 proliferation index affect the prognosis of breast cancer [2– 5], and these methods of evaluating the breast cancer prognosis are obtained invasively via biopsy
Summary
Breast cancer is one of the most common cancers, and the mortality rate of breast cancer ranks first among women [1]. Noninvasive methods to assess the prognosis of breast cancer are urgently needed. As quantitative parameters of SWE, the maximum elasticity (Emax), standard deviation of elasticity (SD), and mean elasticity (Emean) can quantitatively reflect the tissue hardness of the lesion, and the relationship between these parameters and patient clinicopathological characteristics has attracted considerable clinical attention [10]. Determining whether these parameters can be used to quantitatively evaluate the biological behavior of breast cancer has been a major research focus in recent years [11, 12]
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