Evaluating Breast Cancer Biomarkers Using Contrast-enhanced Ultrasound and Shear Wave Elastography

Summary

This protocol demonstrates the combined application of contrast-enhanced ultrasound and shear wave elastography for evaluating biological prognostic factors, including Ki-67, HER2, and ER in breast cancer patients.

Abstract

The purpose of this protocol was to evaluate the relationship between quantitative parameters derived from shear wave elastography (SWE) and contrast-enhanced ultrasound (CEUS) and biological prognostic markers in breast cancer. The study included 68 patients with breast cancer and 68 healthy controls. All patients underwent SWE and CEUS imaging, and surgical specimens from the breast cancer group were analyzed using immunohistochemistry to assess the expression of estrogen receptor (ER), human epidermal growth factor receptor 2 (HER2), and Ki-67.

Results demonstrated that breast cancer tissue exhibited significantly different elastic and perfusion characteristics compared to normal breast tissue. Specifically, the cancer group showed lower E_mean values and higher E_max, E_min, peak intensity, and mean transit time (MTT) values. Correlation analysis revealed that Ki-67 expression was positively correlated with E_mean, E_max, peak, and MTT, while ER was negatively correlated with all parameters except peak intensity. HER2 expression showed positive correlations with all measured imaging parameters. These findings suggest that SWE and CEUS can provide non-invasive, complementary insights to support molecular characterization and clinical evaluation of breast cancer.

Introduction

Breast cancer ranks as one of the most prevalent cancers affecting women worldwide, with incidence rates steadily rising¹. Recent epidemiological studies show that breast cancer is surpassed only by cervical cancer in incidence and remains the leading cause of cancer-related mortality in women overall^2,3. The pathogenesis of breast cancer involves multiple interacting factors, including hereditary traits, endocrine influences, and environmental exposures⁴. With advances in precision medicine, there is a growing interest in understanding the relationships between ....

Protocol

The research was completed in accordance with the Declaration of Helsinki and institutional guidelines for clinical investigations. The protocol for this research was submitted to and approved by the Institutional Ethical Review Committee of The Third Affiliated Hospital of Jinzhou Medical University.

Written informed consent was obtained from all participants prior to enrollment, including permission to utilize de-identified clinical, imaging, and pathological information for future publication. Throughout this research, patient confidentiality was maintained at all times.

The recruitmen....

Results

Patient characteristics

Implementation of this protocol in 68 breast cancer patients and 68 healthy controls demonstrated significant differences in elastographic and perfusion parameters between the groups. All breast cancer cases presented as unilateral lesions, with a mean diameter of 20.78 ± 5.37 mm. Histopathological analysis revealed 49 cases of invasive ductal carcinoma, 9 cases of lobular carcinoma, 6 cases of intraductal carcinoma, 3 cases of mucinous carcinoma, and 1.......

Discussion

This protocol clearly demonstrates the relationship between quantitative ultrasound parameters and molecular prognostic markers in breast cancer, providing a well-defined framework for non-invasive disease characterization. The correlations between imaging parameters and immunohistochemical markers reflect underlying biological changes that affect both the mechanical properties (tissue stiffness) and perfusion characteristics observed during imaging.

Epidemiological studies show that breast ca.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Citrate Buffer (pH 6.0)	12364	Thermo Fisher Scientific	www.thermofisher.com
EDTA Buffer (pH 9.0)	88763	Thermo Fisher Scientific	www.thermofisher.com
Hydrogen Peroxide (3%)	998765	Sigma-Aldrich	www.sigmaaldrich.com
L11-3 Probe (Ultrasound)	ABC987	Myriad Ultrasound	www.myriad.com, 4-15 MHz
SonoVue (Contrast Agent)	12345	Bracco Diagnostics	www.bracco.com
SPSS Statistical Software	N/A	IBM	www.ibm.com