Molecular Subtyping of Breast Cancer: Do We Define Them with B-mode US or ARFI Elastography?

INTRODUCTION: Imaging properties of breast cancer molecular subtypes differ and can be recognized by radiological methods. Acoustic radiation force (ARFI) can be associated with molecular subtypes and grade of breast cancer. The aim of this study was to determine the ultrasound and ARFI elastography correlates of different molecular subtypes of breast cancer.
METHODS: Seventy-two patients were included in the study. The lesions evaluated by B-mod ultrasound (US) and ARFI elastography methods, and US guided tru-cut biopsies were performed. Molecular subtypes were categorized as triple-negative breast cancer(TNBC), luminal A and B, or human epidermal growth factor receptor 2-enriched cancer at based on the immunohistochemical profiles. Clinicopathological features, B-mod US and elastographic features was analized with statistically.
RESULTS: Luminal cancers displayed more frequently an irregular shape, posterior shadowing, echogenic rim, and a hypoechoic or complex echo pattern than TNBC(p˂0.05). While the mean shear wave velocity (SWV) value increased as the lesion size increased, there was no significant difference between the molecular subtypes. In the evaluation of Virtual Touch(TM) Tissue Imaging (VTTI); small lesions showed more frequently pattern 4b, whereas large lesions showed pattern 3.
DISCUSSION AND CONCLUSION: Breast radiologist should be careful, to know that a mass that has a well-defined, posterior enhancement may also be malignant. According to accepted literature data; High SWV values and imaging patterns in VTTI are helpful in this regard to us.