Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Strain Elastography Fat-to-Lesion Index Is Associated with Mammography Bi-rads Grading, Biopsy, and Molecular Phenotype in Breast Cancer.

Jose Alfonso Cruz-Ramos
* ORCID logo ,
Mijail Irak Trapero-Corona
,
Ingrid Aurora Valencia-Hernandez
,
Luz Amparo Gomez-Vargas
,
Maria Teresa Toranzo-Delgado
,
Karla Raquel Cano-Magaña
,
Emmanuel De la Mora-Jimenez
,
Gabriela C. López-Armas
* ORCID logo
Version 1 : Received: 12 December 2023 / Approved: 13 December 2023 / Online: 13 December 2023 (05:06:08 CET)

A peer-reviewed article of this Preprint also exists.

Cruz-Ramos, J.A.; Trapero-Corona, M.I.; Valencia-Hernández, I.A.; Gómez-Vargas, L.A.; Toranzo-Delgado, M.T.; Cano-Magaña, K.R.; De la Mora-Jiménez, E.; del Carmen López-Armas, G. Strain Elastography Fat-to-Lesion Index Is Associated with Mammography BI-RADS Grading, Biopsy, and Molecular Phenotype in Breast Cancer. Biosensors 2024, 14, 94. Cruz-Ramos, J.A.; Trapero-Corona, M.I.; Valencia-Hernández, I.A.; Gómez-Vargas, L.A.; Toranzo-Delgado, M.T.; Cano-Magaña, K.R.; De la Mora-Jiménez, E.; del Carmen López-Armas, G. Strain Elastography Fat-to-Lesion Index Is Associated with Mammography BI-RADS Grading, Biopsy, and Molecular Phenotype in Breast Cancer. Biosensors 2024, 14, 94.

Abstract

Breast cancer (BC) affects millions of women; it is the leading cause of death by neoplasia in wom-en worldwide, with at least 500 thousand deaths each year, 70% of which occur in developing countries. Elastography evaluates tissue stiffness, making this a promising non-invasive real-time technique. BI-RADS is recognized as a standard and helpful technique for establishing BC risk. This study aimed to determine, by strain elastography (SE), the fat-to-lesion index (F/L index), sen-sitivity, specificity, and optimal cut-off to diagnose BC. This prospective study included 216 wom-en who underwent SE, ultrasound, mammography, and breast biopsy; according to mammogra-phy, we recruited BI-RADS category 2 (n= 5), category 3 (n=29), category 4 (n= 94), category 5 (n= 71) and category 6 (n=17); after biopsy, 108 women were classified as negative, and 108 were pos-itive for BC. Three expert BC radiologists performed all imaging interpretations and biopsies. Our results show mean values of the F/L index for negative biopsies of 3.70±2.57 and positive biopsies of 18.10±17.01; we developed two models for the prediction of BC, a logistic regression model with an AUC of 0.893 and a neural network with an AUC of 0.902. The Youden index yielded a F/L index cut-off >5.76, with a sensitivity and specificity of 84.26%. Positive Spearman's Rho cor-relation coefficient was observed between the F/L index and BI-RADS, r=.073 (p< 0.001). ANOVA test showed a difference between F/L index vs. molecular subtypes (p=0.002). SE is helpful as a di-agnostic complement to mammography, or in cases where the latter is contraindicated, elas-tography has an adequate predictive capacity and is a fast and minimally invasive procedure.

Keywords

Elastography; Breast Cancer; fat-to-lesion index

Subject

Medicine and Pharmacology, Oncology and Oncogenics

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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