Lymphangiogenesis in Breast Cancer Correlates with Matrix Stiffness on Shear-Wave Elastography

Yonsei Med J. 2016 May;57(3):599-605. doi: 10.3349/ymj.2016.57.3.599.


Purpose: To correlate tumor stiffness and lymphangiogenesis in breast cancer and to find its clinical implications.

Materials and methods: A total of 140 breast cancer patients were evaluated. Tumor stiffness was quantitatively measured by shear-wave elastography in preoperative ultrasound examination, calculated as mean elasticity value (kPa). Slides of resected breast cancer specimens were reviewed for most fibrotic area associated with tumor. D2-40 immunohistochemical staining was applied for fibrotic areas to detect the lymphatic spaces. Microlymphatic density, tumor stiffness, and clinicopathologic data were analyzed.

Results: Higher elasticity value was associated with invasive size of tumor, microlymphatic density, histologic grade 3, absence of extensive intraductal component, presence of axillary lymph node metastasis, and Ki-67 labeling index (LI) in univariate regression analysis, and associated with Ki-67 LI and axillary lymph node metastasis in multivariate regression analysis. Microlymphatic density was associated histologic grade 3, mean elasticity value, and Ki-67 LI in univariate regression analysis. In multivariate regression analysis, microlymphatic density was correlated with mean elasticity value.

Conclusion: In breast cancer, tumor stiffness correlates with lymphangiogenesis and poor prognostic factors.

Keywords: Breast neoplasms; elasticity imaging techniques; fibrosis; lymphangiogenesis.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast / pathology
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / pathology*
  • Elasticity Imaging Techniques / methods*
  • Female
  • Humans
  • Lymph Nodes / pathology
  • Lymphangiogenesis / physiology*
  • Lymphatic Metastasis / pathology*
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Regression Analysis