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Association of Tumour Stiffness on Sonoelastography with Axillary Nodal Status in T1 Breast Carcinoma Patients

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To evaluate whether tumour stiffness on sonoelastography is associated with axillary nodal metastasis in T1 breast carcinoma patients.


Between May 2006 and December 2010, 200 consecutive women (mean age, 51.6; range, 27 – 81 years) who underwent B-mode ultrasound (US), sonoelastography, and curative surgery with axillary nodal evaluation for clinically node negative T1 breast carcinomas (mean invasive tumour size, 12.4; range, 3 – 20 mm at pathology) were identified. The association between the elasticity score of the tumour and histopathological axillary nodal status was evaluated using a logistic regression model after controlling for imaging and clinicopathological variables of the tumour.


The overall incidence of axillary nodal metastasis was 15.5 % (31 of 200). Axillary nodal metastasis was significantly more frequent in tumours with elasticity scores ≥4 than in tumours with elasticity scores <4 (21.7 % vs. 4.2 %; P < 0.001). At multivariate analysis, an elasticity score ≥4 [odds ratio (OR), 6.95; P = 0.004], US size >10 mm (OR, 5.98; P = 0.022), and lymphovascular invasion (OR, 10.68; P < 0.001) of tumours were independently associated with axillary nodal metastasis.


Tumour stiffness on sonoelastography is independently associated with axillary nodal metastasis in T1 breast carcinoma patients.

Key Points

• Prediction of axillary nodal status using imaging techniques is valuable.

• High ultrasound elasticity scores of T1 tumours were associated with axillary metastasis

• Node-positive T1 tumours frequently had elasticity scores 4 or 5.

• Sonoelastography might render axillary surgery unnecessary in T1 breast carcinoma patients.

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This work was supported by the Industrial Strategic Technology Development Program (10042581) funded by the Ministry of Knowledge Economy (MKE, Korea) and by a National Research Foundation of Korea (NRF) grant funded by the Korean government (MEST) (no. 2012–01010846) and the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (A01185).

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Correspondence to Woo Kyung Moon.

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Yi, A., Moon, W.K., Cho, N. et al. Association of Tumour Stiffness on Sonoelastography with Axillary Nodal Status in T1 Breast Carcinoma Patients. Eur Radiol 23, 2979–2987 (2013).

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