Assessment of Stromal Elastin Fibers in Breast Cancer and Fibroadenomas: Is There a Correlation With Ultrasound Elastography Findings?

Abstract

Objective: The stiffness of a breast lesion provides information on the likelihood of malignancy. The most important factor affecting this stiffness is the composition of the extracellular matrix (ECM). The aim of this study was to assess the elastin fiber contents of malignant breast lesions and fibroadenomas and investigate any relationship between the shear wave velocity (SWV) measured by ultrasonography, and the elastin fiber content of lesions. Materials and Methods: Consecutive patients with breast lesions were enrolled. The SWV values of the lesions were analyzed. Histopathological analysis of elastin in excised lesions was performed by the method of Shivas and Douglas. Breast cancer patients were reviewed according to their lymph node status and tumor diameter. The relationship between SWV value and tissue elastin fiber score was analyzed. The correlation between breast cancer grade and elastin fiber score in malignant lesions was investigated. Results: A total of 167 consecutive breast lesions in 167 patients were included in this study (75 invasive cancer, 92 fibroadenomas). High elastic fiber score was significantly more common (p = 0.001) in malignant lesions (n = 61; 81.3%) than fibroadenomas (n = 13; 14.1%). There was a negative correlation between the mean SWV and the elastin fiber score of fibroadenomas (p = 0.001). A low grade in breast cancer was associated with high elastin fiber score (p = 0.01). Conclusion: Malignant lesions tend to have higher elastin fiber scores than fibroadenomas. Elastin fiber assessment may provide additional prognostic information in malignant lesions. Changes in elastin fiber content may account for the variation in elasticity in fibroadenomas.