title: Do Histopathological Features and Microcalcification Affect the Elasticity of Breast Cancer?
abstract: OBJECTIVE
  The aim of this study was to evaluate any association between histological grade, molecular subtypes of breast cancer, and strain elastography, and to investigate whether microcalcification affects the stiffness of tumor in breast cancers with the same histological grade.
  
  
  METHODS
  Between April 2015 and March 2016, 94 lesions of 94 patients with the diagnosis of invasive ductal carcinoma were included in the study. Strain elastography was performed on all patients before biopsy. Histological grades (Grades 1, 2, and 3), molecular subtypes (luminal A, luminal B, Her-2, and basal-like), and strain ratio (SR) were compared. In the same histological grades, patients were divided into two groups according to the presence of microcalcifications, and the groups were compared with each other.
  
  
  RESULTS
  Compared with Grades 1 (20.5) and 2 (23.7), Grade 3 (11.7) showed lower SR values (Grade 3-2, P = .01; Grade 3-1, P = .2). The groups with microcalcification had slightly higher SR in all histological grades, but not of statistical significance. In molecular subtypes, luminal A and B demonstrated higher SR, whereas HER2 and basal-like had lower SR (P > .05 for all group comparisons).
  
  
  CONCLUSIONS
  Grade 3 invasive ductal carcinomas are different from other grades with lower SR values. The presence of microcalcifications and molecular subtypes do not affect elasticity like a high histological grade does.
authors.affiliation: Department of Radiology, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Gamze
authors.initials: G
authors.lastname: Durhan
authors.affiliation: Department of Radiology, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Pelin Seher
authors.initials: PS
authors.lastname: Öztekin
authors.affiliation: Department of Pathology, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Hatice
authors.initials: H
authors.lastname: Ünverdi
authors.affiliation: Department of Radiology, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Tülin
authors.initials: T
authors.lastname: Değirmenci
authors.affiliation: Department of General Surgery, Surgical Oncology Unit, Ankara University Medical School, Ankara, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Durhan
authors.affiliation: Department of Biostatistics, Hacettepe University Medical School, Ankara, Turkey.
authors.forename: Jale
authors.initials: J
authors.lastname: Karakaya
authors.affiliation: Department of Radiology, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Pınar
authors.initials: P
authors.lastname: Nercis Koşar
authors.affiliation: Department of Radiology, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Enver
authors.initials: E
authors.lastname: Necip Köseoğlu
authors.affiliation: Department of Pathology, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Sema
authors.initials: S
authors.lastname: Hücümenoğlu
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D060787:Neoplasm Grading; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013314:Stress, Mechanical
keywords: breast cancer; elasticity; histopathology; microcalcification