Open AccessCorrelating Tumor Stiffness with Immunohistochemical Subtypes of Breast Cancers: Prognostic Value of Comb-Push Ultrasound Shear Elastography for Differentiating Luminal Subtypes
Author(s) -
Max Denis,
Adriana Gregory,
Mahdi Bayat,
Robert T. Fazzio,
Dana H. Whaley,
Karthik Ghosh,
Sejal Shah,
Mostafa Fatemi,
Azra Alizad
Publication year - 2016
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0165003
Subject(s) - medicine , breast cancer , immunohistochemistry , elastography , ultrasound , pathology , clinical significance , elasticity (physics) , lymph node , statistical significance , cancer , oncology , radiology , materials science , composite material
Purpose The purpose of our study is to correlate quantitatively measured tumor stiffness with immunohistochemical (IHC) subtypes of breast cancer. Additionally, the influence of prognostic histologic features (cancer grade, size, lymph node status, and histological type and grade) to the tumor elasticity and IHC profile relationship will be investigated. Methods Under an institutional review board (IRB) approved protocol, B-mode ultrasound (US) and comb-push ultrasound shear elastography (CUSE) were performed on 157 female patients with suspicious breast lesions. Out of 157 patients 83 breast cancer patients confirmed by pathology were included in this study. The association between CUSE mean stiffness values and the aforementioned prognostic features of the breast cancer tumors were investigated. Results Our results demonstrate that the most statistically significant difference ( p = 0.0074) with mean elasticity is tumor size. When considering large tumors (size ≥ 8mm), thus minimizing the statistical significance of tumor size, a significant difference ( p< 0 . 05 ) with mean elasticity is obtained between luminal A of histological grade I and luminal B (Ki-67 > 20%) subtypes. Conclusion Tumor size is an independent factor influencing mean elasticity. The Ki-67 proliferation index and histological grade were dependent factors influencing mean elasticity for the differentiation between luminal subtypes. Future studies on a larger group of patients may broaden the clinical significance of these findings.