Association between real-time shear wave elastography findings and HER-2 expression in breast cancer

Human epidermal growth factor receptor-2 (HER-2) overexpressing breast cancer is associated with more aggressive tumor characteristics and poorer clinical outcomes. It is important to determine HER-2 status of breast cancer for better treatment planning. This study aims to explore the correlation between real-time shear wave elastography (SWE) and HER-2 expression in breast cancer. A total of 67 patients who underwent breast cancer surgery between January 2017 and January 2021 were recruited for this retrospective study. Among 70 breast cancer lesions in the included patients, 31 lesions were HER-2 negative, and 39 lesions were HER-2 positive. SWE imaging was conducted and Young's modulus values including mean elastic modulus (Emean), maximum elastic modulus (Emax), and minimum elastic modulus (Emin) were measured. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic efficacy of the imaging parameters for HER-2 positivity. The HER-2 positive group had a higher proportion of lesions with a diameter of ≥20 mm. The Emax value was significantly lower in the HER-2 positive group compared to the negative group (P<0.05). The highest area under the curve (AUC) value (0.800) was observed for the combination of Emax, lesion size, and calcification, with a sensitivity of 66.7% and specificity of 83.9%. Emax combined with lesion size and calcification showed a moderate association with HER-2 positivity, suggesting a potential role for SWE in complementing established diagnostic methods. These findings suggest that SWE parameters, in particular Emax may be useful in the non-invasive assessment of HER-2 status in breast cancer.