title: Associations Between Elastography Findings and Clinicopathological Factors in Breast Cancer.
abstract: This study aimed to explore the clinical significance of breast tumor tissue stiffness based on ultrasound elastographic evaluation in clinical breast cancer. Tumor tissue stiffness is mainly regulated by interactions among tumor cells, stromal cells, and extracellular matrix and was recently regarded as a representative feature of tumor microenvironment. Basic research has already revealed that the tumor stiffness can lead to tumor progression; however, little is known about its clinical significance because thus far, no useful modality is available in the clinical setting. We investigated the tumor stiffness by strain elastography in 503 consecutive patients with invasive breast cancer. Correlations between stiffness and clinicopathological factors, including tumor size, lymph node involvement, tumor subtypes, and stromal-related genes' expressions in primary breast tumor, were statistically examined. We identified that clinical tumor stiffness significantly correlated with lymph node involvement and invasive tumor size but not with hormonal receptor expressions, human epidermal growth factor receptor type 2 status, and ki67 labeling index by analyses of both categorical and continuous variables of stiffness. On multivariate analyses, axillary lymph node metastasis was an independent factor that influenced the stiffness of primary breast tumor. In the gene expression analyses, relatively hard tumors had a significantly high gene expression of lysyl oxidase compared with soft tumors. Our study showed a close relationship between primary tumor stiffness by elastographic evaluation and lymph node involvement in clinical breast cancer. Further investigations on tumor-related tissue stiffness are required.
authors.affiliation: From the Department of Breast and Endocrine Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (MH, YY, AS, MT, MY-I, HI); Division of Clinical Pharmacology and Translational Research, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Tokyo, Japan (MH, AH); Department of Breast and Endocrine Surgery, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan (TK); and Department of Molecular Imaging and Pharmacokinetics, Fundamental Innovative Oncology Core, National Cancer Center Research Institute, Tokyo, Japan (MH, AH).
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Hayashi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Aiko
authors.initials: A
authors.lastname: Sueta
authors.forename: Mai
authors.initials: M
authors.lastname: Tomiguchi
authors.forename: Mutsuko
authors.initials: M
authors.lastname: Yamamoto-Ibusuki
authors.forename: Teru
authors.initials: T
authors.lastname: Kawasoe
authors.forename: Akinobu
authors.initials: A
authors.lastname: Hamada
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Iwase
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000378:metabolism; D012189:Retrospective Studies; D017154:Stromal Cells
chemical_list: D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins