title: Correlating Tumor Stiffness with Immunohistochemical Subtypes of Breast Cancers: Prognostic Value of Comb-Push Ultrasound Shear Elastography for Differentiating Luminal Subtypes.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Radiology, Mayo Clinic, Rochester, MN, 55905, United States of America.
authors: Max
authors: M
authors: Denis
authors: Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, 55905, United States of America.
authors: Adriana
authors: A
authors: Gregory
authors: Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, 55905, United States of America.
authors: Mahdi
authors: M
authors: Bayat
authors: Department of Radiology, Mayo Clinic, Rochester, MN, 55905, United States of America.
authors: Robert T
authors: RT
authors: Fazzio
authors: Department of Radiology, Mayo Clinic, Rochester, MN, 55905, United States of America.
authors: Dana H
authors: DH
authors: Whaley
authors: Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN, 55905, United States of America.
authors: Karthik
authors: K
authors: Ghosh
authors: Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, United States of America.
authors: Sejal
authors: S
authors: Shah
authors: Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, 55905, United States of America.
authors: Mostafa
authors: M
authors: Fatemi
authors: Department of Radiology, Mayo Clinic, Rochester, MN, 55905, United States of America.|Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, 55905, United States of America.|Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN, 55905, United States of America.
authors: Azra
authors: A
authors: Alizad
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D060787:Neoplasm Grading; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D016217:Ultrasonography, Mammary / Q000379:methods
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human