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

toprak, nurşen; Gündüz, Ali Mahir; aras, ibrahim; toktas, Osman; YOKUŞ, ADEM

doi:10.4274/ejbh.galenos.2022.2021-8-3

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

Nurşen TOPRAK, (Van Yüzüncü Yıl Üniversitesi Tıp Fakültesi, Radyoloji Anabilim Dalı, Van, Türkiye)

İbrahim ARAS, (Van Yüzüncü Yıl Üniversitesi Tıp Fakültesi Patoloji Anabilim Dalı, Van, Türkiye)

Osman TOKTAŞ, (Van Yüzüncü Yıl Üniversitesi Genel Cerrahi Anabilim Dalı, Tıp Fakültesi, Van, Türkiye)

Adem YOKUŞ, (Van Yüzüncü Yıl Üniversitesi Tıp Fakültesi, Radyoloji Anabilim Dalı, Van, Türkiye)

Ali Mahir GÜNDÜZ (Van Yüzüncü Yıl Üniversitesi Tıp Fakültesi, Radyoloji Anabilim Dalı, Van, Türkiye)

European Journal of Breast Health

0 0

Yıl: 2022 Cilt: 18 Sayı: 2 Sayfa Aralığı: 134 - 140 Metin Dili: İngilizce DOI: 10.4274/ejbh.galenos.2022.2021-8-3 İndeks Tarihi: 21-06-2022

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

Öz:

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.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Kristensen JH, Karsdal MA. Elastin. In: Karsdal MA, editor. Biochemistry of Collagens, Laminins and Elastin.1st ed. Elsevier; 2016. pp. 197-202. [Crossref ]
2. Oskarsson T. Extracellular matrix components in breast cancer progression and metastasis. Breast 2013; 22(Suppl 2): 66-72. (PMID: 24074795) [Crossref ]
3. Acerbi I, Cassereau L, Dean I, Shi Q, Au A, Park C, et al. Human breast cancer invasion and aggression correlates with ECM stiffening and immune cell infiltration. Integr Biol (Camb) 2015; 7: 1120-1134. (PMID: 25959051) [Crossref ]
4. Wang ZL, Sun L, Li Y, Li N. Relationship between elasticity and collagen fiber content in breast disease: a preliminary report. Ultrasonics 2015; 57: 44-49. (PMID: 25465961) [Crossref ]
5. Shi XQ, Li J, Qian L, Xue X, Li J, Wan W. Correlation between elastic parameters and collagen fibre features in breast lesions. Clin Radiol 2018; 73: 595. (PMID: 29510833) [Crossref ]
6. Xiao Y, Yu Y, Niu L, Qian M, Deng Z, Qiu W, et al. Quantitative evaluation of peripheral tissue elasticity for ultrasound-detected breast lesions. Clin Radiol 2016; 71: 896-904. (PMID: 27349474) [Crossref ] 7. Kadar A, Tõkés AM, Kulka J, Robert L. Extracellular matrix components in breast carcinomas. Semin Cancer Biol 2002; 12: 243-257. (PMID: 12083854) [Crossref ]
8. Martinez-Hernandez A, Francis DJ, Silverberg SG. Elastosis and other stromal reactions in benign and malignant breast tissue: an ultrastructural study. Cancer 1977; 40: 600-606. (PMID: 196733) [Crossref ]
9. Davies JD, Barnard K, Young EW. Immunoreactive elastin in benign breast tissues. An immunoperoxidase study. Virchows Arch A Pathol Anat Histopathol 1982; 398: 109-117. (PMID: 6819699) [Crossref ]
10. Lee SH, Moon WK, Cho N, Chang JM, Moon HG, Han W, et al. Shearwave elastographic features of breast cancers: comparison with mechanical elasticity and histopathologic characteristics. Invest Radiol 2014; 49: 147- 155. (PMID: 24169069) [Crossref ]
11. Liu G, Zhang MK, He Y, Li XR, Wang ZL. Shar wave elasticity of breast lesions: would it be correlated with the extracellular matrix components? Gland Surg 2019; 8: 399-406. (PMID: 31538065) [Crossref ] 12. American College of Radiology. ACR BI-RADS-US. In: ACR breast imaging reporting and data system. Reston: American College of Radiology; 2013.
13. Douglas JG, Shivas AA. The origins of elastica in breast carcinoma. J R Coll Surg Edinb 1974; 19: 89-93. (PMID: 4824318) [Crossref ]
14. Bloom HJ, Richarson WW. Histologic grading and prognosis in breast cancer; A study of 1409 cases of which 359 have been followed for 15 years. Br J Cancer 1957; 11: 359-377. (PMID: 13499785) [Crossref ]
15. Ghosh L, Ghosh BC, Das Gupta TK. Ultrastructural study of stroma in human mammary carcinoma. Am J Surg 1980; 139: 229-232. (PMID: 6243882) [Crossref ]
16. Jalkanen S, Salmi M. Cell surface monoamine oxidases: enzymes in search of a function. Embo J 2001; 20: 3893-3901. (PMID: 11483492) [Crossref ]
17. Chamming’s F, Latorre-Ossa H, Le Frère-Belda MA, Fitoussi V, Quibel T, Assayag F, et al. Shear wave elastography of tumour growth in a human breast cancer model with pathological correlation. Eur Radiol 2013; 23: 2079-2086. (PMID: 23553589) [Crossref ]
18. Parfrey NA, Doyle CT. Elastosis in benign and malignant breast disease. Hum Pathol 1985; 16: 674-676. (PMID: 2989149) [Crossref ]
19. Azzopardi JG. Elastosis and other connective tissue changes. In: W. B. Saunders, editor. Problems in Breast Pathology. 1st ed. London: 1976. p. 379-394.
20. Chen Y, Klingen TA, Wik E, Aas H, Vigeland E, Liestøl K, et al. Breast cancer stromal elastosis is associated with mammography screening detection, low Ki 67 expression and favourable prognosis in a populationbased study. Diagn Pathol 2014 ;9: 230. (PMID: 25522915) [Crossref ]
21. Mera SL, Davies JD. Elastosis in breast carcinoma: I. Immunohistochemical characterization of elastic fibres. J Pathol 1987; 151: 103-110. (PMID: 3033189) [Crossref ]
22. Isaacson C, Greeff H, Murray JF, Posen J, Schmaman A. Elastosis in malignant tumours. S Afr Med J 1985; 68: 30-32. (PMID: 2990055) [Crossref ]
23. Ushiki T. Collagen Fibers, Reticular Fibers and Elastic Fibers. A Comprehensive Understanding from a Morphological Viewpoint. Arch Histol Cytol 2002; 65: 109-126. (PMID: 12164335) [Crossref ]
24. Zakout YM, Abdullah SM, Ali MA. Assessment of Elastosis in Invasive Ductal Carcinoma of the Breast Compared to Fibroadenoma among Sudanese Patients Using Conventional Histochemical Methods. Biotech Histochem 2012; 87: 122-225. (PMID: 21375429) [Crossref ]
25. Elasbali AM, Onzi ZA, Hamza A, Khalafalla E, Ahmed HG. Morphological Patterns of Elastic and Reticulum Fibers in Breast Lesions. Health 2018; 10: 1625-1633. [Crossref ]
26. Elseedawy M, Whelehan P, Vinnicombe S, Thomson K, Evans A. Factors influencing the stiffness of fibroadenomas at shear wave elastography. Clin Radiol 2016; 71: 92-95. (PMID: 26654133) [Crossref ]
27. Lee KH, Kim SJ, Park YM, Kim W, Yoon JH, Song JW, et al. Grayscale and color Doppler sonographic features of complex fibroadenomas of the breast. J Clin Ultrasound 2015; 43: 556-662. (PMID: 26200475) [Crossref ]
28. Humphrey PA, Dehner LP, Pfeifer JD, editors. The Washington Manual of Surgical Pathology. 1st ed. Lippincott Williams & Wilkins; 2008.
29. Dupont WD, Page DL, Parl FF, Vnencak-Jones CL, Plummer WD Jr, Rados MS, et al. Long-term risk of breast cancer in women with fibroadenoma. N Engl J Med 1994; 331: 10-15. (PMID: 8202095) [Crossref ]

APA	toprak n, aras i, toktas O, YOKUŞ A, Gündüz A (2022). Assessment of Stromal Elastin Fibers in Breast Cancer and Fibroadenomas: Is There a Correlation With Ultrasound Elastography Findings?. , 134 - 140. 10.4274/ejbh.galenos.2022.2021-8-3
Chicago	toprak nurşen,aras ibrahim,toktas Osman,YOKUŞ ADEM,Gündüz Ali Mahir Assessment of Stromal Elastin Fibers in Breast Cancer and Fibroadenomas: Is There a Correlation With Ultrasound Elastography Findings?. (2022): 134 - 140. 10.4274/ejbh.galenos.2022.2021-8-3
MLA	toprak nurşen,aras ibrahim,toktas Osman,YOKUŞ ADEM,Gündüz Ali Mahir Assessment of Stromal Elastin Fibers in Breast Cancer and Fibroadenomas: Is There a Correlation With Ultrasound Elastography Findings?. , 2022, ss.134 - 140. 10.4274/ejbh.galenos.2022.2021-8-3
AMA	toprak n,aras i,toktas O,YOKUŞ A,Gündüz A Assessment of Stromal Elastin Fibers in Breast Cancer and Fibroadenomas: Is There a Correlation With Ultrasound Elastography Findings?. . 2022; 134 - 140. 10.4274/ejbh.galenos.2022.2021-8-3
Vancouver	toprak n,aras i,toktas O,YOKUŞ A,Gündüz A Assessment of Stromal Elastin Fibers in Breast Cancer and Fibroadenomas: Is There a Correlation With Ultrasound Elastography Findings?. . 2022; 134 - 140. 10.4274/ejbh.galenos.2022.2021-8-3
IEEE	toprak n,aras i,toktas O,YOKUŞ A,Gündüz A "Assessment of Stromal Elastin Fibers in Breast Cancer and Fibroadenomas: Is There a Correlation With Ultrasound Elastography Findings?." , ss.134 - 140, 2022. 10.4274/ejbh.galenos.2022.2021-8-3
ISNAD	toprak, nurşen vd. "Assessment of Stromal Elastin Fibers in Breast Cancer and Fibroadenomas: Is There a Correlation With Ultrasound Elastography Findings?". (2022), 134-140. https://doi.org/10.4274/ejbh.galenos.2022.2021-8-3

APA	toprak n, aras i, toktas O, YOKUŞ A, Gündüz A (2022). Assessment of Stromal Elastin Fibers in Breast Cancer and Fibroadenomas: Is There a Correlation With Ultrasound Elastography Findings?. European Journal of Breast Health, 18(2), 134 - 140. 10.4274/ejbh.galenos.2022.2021-8-3
Chicago	toprak nurşen,aras ibrahim,toktas Osman,YOKUŞ ADEM,Gündüz Ali Mahir Assessment of Stromal Elastin Fibers in Breast Cancer and Fibroadenomas: Is There a Correlation With Ultrasound Elastography Findings?. European Journal of Breast Health 18, no.2 (2022): 134 - 140. 10.4274/ejbh.galenos.2022.2021-8-3
MLA	toprak nurşen,aras ibrahim,toktas Osman,YOKUŞ ADEM,Gündüz Ali Mahir Assessment of Stromal Elastin Fibers in Breast Cancer and Fibroadenomas: Is There a Correlation With Ultrasound Elastography Findings?. European Journal of Breast Health, vol.18, no.2, 2022, ss.134 - 140. 10.4274/ejbh.galenos.2022.2021-8-3
AMA	toprak n,aras i,toktas O,YOKUŞ A,Gündüz A Assessment of Stromal Elastin Fibers in Breast Cancer and Fibroadenomas: Is There a Correlation With Ultrasound Elastography Findings?. European Journal of Breast Health. 2022; 18(2): 134 - 140. 10.4274/ejbh.galenos.2022.2021-8-3
Vancouver	toprak n,aras i,toktas O,YOKUŞ A,Gündüz A Assessment of Stromal Elastin Fibers in Breast Cancer and Fibroadenomas: Is There a Correlation With Ultrasound Elastography Findings?. European Journal of Breast Health. 2022; 18(2): 134 - 140. 10.4274/ejbh.galenos.2022.2021-8-3
IEEE	toprak n,aras i,toktas O,YOKUŞ A,Gündüz A "Assessment of Stromal Elastin Fibers in Breast Cancer and Fibroadenomas: Is There a Correlation With Ultrasound Elastography Findings?." European Journal of Breast Health, 18, ss.134 - 140, 2022. 10.4274/ejbh.galenos.2022.2021-8-3
ISNAD	toprak, nurşen vd. "Assessment of Stromal Elastin Fibers in Breast Cancer and Fibroadenomas: Is There a Correlation With Ultrasound Elastography Findings?". European Journal of Breast Health 18/2 (2022), 134-140. https://doi.org/10.4274/ejbh.galenos.2022.2021-8-3