TGF-ß1: is it related to the stiffness of breast lesions and can it predict axillary lymph node metastasis?

BACKGROUND: This study aimed to explore whether transforming growth factor ß1 (TGF-ß1) is correlated with the stiffness of breast lesions and if it can predict axillary lymph node (ALN) metastasis. METHODS: A retrospective analysis was performed in our hospital. A total of 135 breast lesions in 130 patients who were to undergo vacuum-assisted excisional biopsy (VAEB) or surgery were enrolled between April 2018 and October 2018. Ultrasound (US) and shear wave elastography (SWE) examinations were performed for every lesion before VAEB or surgery. Pathology results obtained by VAEB or surgery were regarded as gold criteria. The elastic parameters and TGF-ß1 expression level of malignant breast lesions were compared with those of benign lesions; the relationship between TGF-ß1 expression level in breast lesions and the elastic parameters was analyzed; the TGF-ß1 expression level in breast lesions with or without ALN metastasis were compared; and the efficacy of TGF-ß1 expression level in predicting ALN metastasis was analyzed. RESULTS: The malignant breast lesions were different from benign lesions in the maximum and mean elasticity (Emax, Emean), standard deviation of elasticity (ESD), elastic ratio of the lesions to the peripheral tissue (Eratio), and the occurrence rate of "stiff rim sign" (P<0.001). The expression level of TGF-ß1 in benign breast lesions was significantly lower than that in malignant lesions (P<0.001), and the TGF-ß1 expression level was positively correlated with Emax, Emean, ESD, and Eratio (r=0.869, 0.840, 0.834, and 0.734, respectively). The expression level of TGF-ß1 in breast lesions with or without "stiff rim sign" was significantly different (P<0.001), and the TGF-ß1 expression level in malignant breast lesions with ALN metastasis was significantly higher than that in malignant lesions without ALN metastasis (P=0.0009). When TGF-ß1 expression level >0.3138 was taken as the cut-off value, its efficacy in predicting ALN metastasis was 0.853, with a sensitivity of 86.67%, and a specificity 83.33%. CONCLUSIONS: The expression level of TGF-ß1 was positively correlated with the elastic parameters of breast lesions, and it could be useful for predicting ALN metastasis, especially for negative ALN diagnosis clinically.

Ultrasound-guided vacuum-assisted excisional biopsy to treat benign phyllodes tumors.

PURPOSE: To evaluate the value of ultrasound (US)-guided vacuum-assisted excisional biopsy (VAB) in treating benign phyllodes tumors (PTs) of the breasts and to investigate the lesion characteristics that could affect the local recurrence rate. PATIENT AND METHODS: From December 2008 to February 2018, 93 patients with PTs diagnosed on histology underwent US-guided, 7-gauge VAB. The recurrence rate of benign PT and complications of VAB were evaluated on follow-up US every three to six months. The lesion characteristics were analyzed to identify the factors affecting the recurrence rate. RESULTS: Of the 87 patients, local recurrence was found in 15 patients (17%) in a mean follow-up period of 35.8 months, and the rate of complete excision was 82.8% (72/87). PTs with a largest diameter less than 3.3 cm had a significantly lower recurrence rate than PTs with a largest diameter larger than 3.3 cm (P < 0.05). CONCLUSIONS: In conclusion, US-guided VAB is an effective method to treat benign PT, especially in lesions with a diameter less than 3.3 cm.