Study On The Correlation Between Shear Wave Modulus Of Elasticity And Biological Characteristics Of Breast Tumors

Objective: The maximum elastic modulus(Emax)and mean(Emean)of benign and malignant breast tumors were quantitatively determined by shear-wave elastography(SWE).The clinical stage,histological grade,mass size,and armpit were investigated.The relationship between lymph node metastasis,vascular invasion and molecular subtypes of breast cancer was evaluated for its diagnostic value and clinical significance.Methods: A total of 465 lesions of 415 cases of breast tumor confirmed by pathology were examined by SWE before operation.The Emax and Emean values of breast masses were measured and averaged three times.The maximum diameter of the mass was measured under conventional ultrasound and recorded.Review the pathological system,obtain the clinical stage of the mass,histological grade,mass size,immunohistochemistry(ER,PR,HER-2,Ki-67 expression),and divide it into 4 molecular subtypes: Luminal A type,Luminal B type,HER-2 overexpression type,three negative type.The receiver operating characteristic curve(ROC)of the elastic modulus value was calculated,and the area under the curve(AUC)was calculated to obtain the optimal diagnostic threshold for benign and malignant breast tumors.The Emax of the breast mass was analyzed.The relationship between Emean and its size,clinical stage,and histological grade;the difference of Emax and Emean between the axillary lymph node metastasis and vascular invasion positive group and the negative group;the difference between Emax and Emean of different molecular subtypes of breast cancer.Results: 1.The Emax and Emean in breast cancer group were significantly higher than those in benign tumors group(P < 0.05).ROC curves showed that the diagnostic thresholds of Emax and Emean in benign and malignant tumors were 60.5 k Pa and 31.5 k Pa,respectively.2.The Emax and Emean were significantly higher in advanced breast cancer(stage III+IV)than in early breast cancer(stage I and II)and higher in stage II than in stage I.Highly differentiated breast cancer(stage I)was significantly lower than moderately and poorly differentiated breast cancer(stage II and III)with statistical significance(P < 0.05).Tumor size was positively correlated with Emax and Emean.3.The Emax and Emean in axillary lymph node metastasis group were higher than those in non-lymph node metastasis group,with statistical significance(P < 0.05);Emax and Emean in vascular(+)group were higher than those in vascular(-)group,with statistical significance(P < 0.05).4.The Emax values of breast cancer with different molecular subtypes were different,and the difference was statistically significant(P < 0.05).Emax values of HER-2 overexpression breast cancer were the highest,followed by Luminal B,triple negative breast cancer and Luminal A breast cancer.Emean had no significant difference among different molecular subtypes of breast cancer(P > 0.05).Conclusions: 1.The SWE quantitative diagnosis technology has high clinical diagnostic value in the diagnosis of breast benign and malignant tumors,and Emax is superior to Emean in diagnostic efficiency;2.The Emax of breast cancer mass has a certain correlation with its pathological characteristics and molecular typing.The higher the clinical stage,the higher the histological grade,the larger the diameter of the mass,axillary lymph node metastasis and vascular invasion,the greater the modulus of elasticity.The biological characteristics of breast cancer affect its hardness.