Can Ultrasonographic Vascular and Elastographic Features of Invasive Ductal Breast Carcinoma Predict Histologic Aggressiveness?

RATIONALE AND OBJECTIVES

To investigate if preoperative ultrasonographic vascular and shear-wave elastographic examinations can predict histologic aggressiveness.

MATERIALS AND METHODS

Preoperative ultrasonographic vascular features and shear-wave elasticities were retrospectively evaluated for 147 invasive ductal carcinomas. Vascular feature was assessed using four-tier vascularity score. Mean and maximum elasticities (Emean and Emax), and the lesion-to-fat ratio (Eratio) were documented. Histologic parameters were reviewed for tumor size, multiplicity, axillary lymph node status, lymphovascular invasion, histologic grade, estrogen receptor, progesterone receptor, human epidermal growth factor receptor2 (HER2), Ki-67, p53, and histologic subtype. Vascularity score and elasticities were correlated with histologic parameters and histologic parameters were compared between the group with low vascularity score and elasticities and the group with high vascularity score and elasticities using ANOVA, chi-squared test, and regression analysis.

RESULTS

Vascularity score was independently associated with tumor size (p = 0.010) and HER2 (p = 0.007). Emean and Emax were associated with tumor size, histologic grade, and lymphovascular invasion, and Eratio was associated with tumor size, histologic grade, estrogen receptor, progesterone receptor, Ki-67, and histologic subtype (p < 0.05). Emean and Emax were independently associated with tumor size (p < 0.001). The group with high vascularity score and Eratio showed large tumor size (p < 0.001) and HER2 positivity (p = 0.039) in comparison to the group with low vascularity score and Eratio.

CONCLUSION

Ultrasonographic vascular features were associated with tumor size and HER2. SWE elasticities were associated with tumor size, histologic grade, hormonal receptor, and histologic subtype. Therefore, preoperative vascular and elastographic examinations could predict histologic aggressiveness of invasive ductal breast carcinoma.