Feasibility of Shear Wave Elastography Imaging for Evaluating the Biological Behavior of Breast Cancer

OBJECTIVE: To explore the feasibility of shear wave elastography (SWE) parameters for assessing the biological behavior of breast cancer. MATERIALS AND METHODS: In 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 (S(max)) 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 (E(max)), mean elasticity (E(mean)), 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. RESULTS: In 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 S(max) (p = 0.000) values increased. In the ALN-positive group, S(max) (p = 0.004) was significantly greater than in the ALN-negative group; S(max) (p = 0.003), E(max) (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 S(max) (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 S(max) (p = 0.002) of the HER2(+) group showed higher values than that of the HER2(-) group; S(max) (p = 0.000), SD (p = 0.006), and E(max) (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 S(max) (p = 0.005), E(max) (p = 0.004), and SD (p = 0.006); ER was an independent influencing factor of S(max) (p = 0.000) and AR (p = 0.032). LVI independently influences S(max) (p = 0.006). CONCLUSIONS: The SWE parameters E(max), SD, and AR can be used to evaluate the biological behavior of breast cancer.