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

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 Emean values and higher Emax, Emin, peak intensity, and mean transit time (MTT) values. Correlation analysis revealed that Ki-67 expression was positively correlated with Emean, Emax, 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.