Could the “Stiff Rim Sign” Be an Indicator of Lysyl Oxidase Activity in Breast Cancer?

Shear wave elastography (SWE) is a non-invasive and easily applicable imaging modality, which can provide quantitative information of tissue stiffness. Peritumoral high SWE elasticity values (stiff rim sign) has been reported in many studies. Lysyl oxidase (LOX) enzyme is implicated in the formation of peri-tumoral stiffness. The aim of the study was to investigate the correlation between SWE measures with LOX gene expression levels in breast cancer patients.
Patients and Forty seven women were included in the study. The lesions evaluated by SWE and ultrasound guided tru-cut biopsies were performed from both of the central and peripheral parts. SWE values, LOX family gene expression levels, histopathological features of the lesions, as well as axillary and distant metastasis statuses were evaluated statistically. Thirty of the patients had breast cancer (BC) (the patient group) and 17 of them had fibroadenoma (the control group). Lysyl oxidase like1 (LOXL1) expression level in BC samples (central parts) were found to be significantly higher than the control group (P = 0.022). Stiff rim sign was present in all BC lesions and none of the control group. The elastography values of the patient group were significantly higher than the control group statistically (P < 0.05). There was no statistically significant relationship between LOX, LOXL1, LOXL2 expressions and SWE parameters (P > 0.05) both for patient and control groups. Although there were no significant correlations between LOX expressions and SWE parameters in our study, axillary and distant metastasis were found to be correlated with SWE features, which emphasized the prognostic potential of SWE.