title: Strain elastography for prediction of breast cancer tumor grades.
abstract: OBJECTIVE
  The purpose of this study was to determine whether the elasticity imaging/B-mode ratio on strain elastography can predict breast cancer tumor grades.
  
  
  METHODS
  A retrospective review of patients with breast lesions who underwent strain elastography and had a diagnosis of breast cancer by image-guided or surgical biopsy was performed. The axis of the maximum elastographic dimension was compared to the B-mode dimension to form an elasticity imaging/B-mode ratio. Lesions were categorized according to their pathologic type, including atypical ductal hyperplasia (ADH), mucinous or colloid cancer, ductal carcinoma in situ (DCIS), grade I invasive ductal carcinoma (IDC), grade II IDC, grade III IDC, invasive lobular carcinoma (ILC), and lymphoma. The mean elasticity imaging/B-mode ratio of each tumor type was calculated. The elasticity imaging/B-mode ratio of the tumor was compared to the tumor type by Kruskal-Wallis and Tukey-Kramer tests (lymphoma and ADH excluded because of small numbers).
  
  
  RESULTS
  Tumor grades included lymphoma (n = 3), ADH (n = 2), mucinous cancer (n = 11), DCIS (n = 19), IDC (grades I-III; n = 200), and ILC (n = 31). The mean elasticity imaging/B-mode ratio varied with increasing tumor grade. Tumor grades could not have been selected at random from one population (P < .0001, χ(2) test). Invasive lobular carcinoma and grade III IDC were statistically different from mucinous or colloid cancer, DCIS, and grade I and II IDC.
  
  
  CONCLUSIONS
  The elasticity imaging/B-mode ratio on strain elastography is related to the tumor grade.
authors.affiliation: Department of Radiology, University of South Florida, Morsani College of Medicine, 2 Tampa General Cir, STC 7035, Tampa, FL 33606-3571 USA. E-mail address: jgrajo@health.usfedu.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Grajo
authors.forename: Richard G
authors.initials: RG
authors.lastname: Barr
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008875:Middle Aged; D060787:Neoplasm Grading; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000379:methods*
keywords: breast; breast cancer; breast ultrasound; elastography; strain; tumor grade