Evaluation of the Effect of Age, Menopausal Status, and Parity on Breast Parenchyma Stiffness by Multiparametric Shear Wave Elastography

Published:October 23, 2021DOI:


      • There is a direct relationship between age, menopausal status, parity, mammographic breast density with elastographic breast stiffness.
      • All mpSWE values were found to be higher in nulliparous and post-menopausal women than premenopausal patients with prior parity.
      • The elastographic breast stiffness in type C and D breast density by mamography is higher than type A and B breast density.

      Rationale and Objectives

      To evaluate the relationship between quantitative breast parenchyma stiffness by using multiparametric shear wave elastography (mpSWE) and the potential risk factors of breast cancer.

      Material and methods

      The Vmean, Vmax, Vmin, Vsd values were measured with mpSWE from each breast and each quadrant in all cases under and over the age of 40. Statistical analysis was performed to evaluate the relationship between breast stiffness and age, side, quadrant, menopausal status, mammographic breast density, and obstetric history.


      The study cohort included 964 breasts of 482 patients, where 342 patients were ≥40 years of age; and 140 cases were <40 years of age with a mean age of 45.07 ± 10.96. No significant difference in breast stiffness was detected between right and left breasts (p > 0.05); however, upper quadrants were found to be stiffer than the lower quadrants (p < 0.05). The effect of age on all values was found to be significant (p < 0.05), and stiffness increased with age. All mpSWE values of post-menopausal cases were significantly higher (p < 0.05) than premenopausal cases. Nulliparous cases had higher values than cases with prior parity (p < 0.05). Cases with Type C and D breast density had higher stiffness values than those with Type A and Type B breast density.


      Breast parenchyma shows increased stiffness in in post-menopausal, nulliparous and older patients and patients with dense breast density. Similar to the mammographic increased breast density, elastographically increased breast parenchymal stiffness may be used as a possible risk factor for breast cancer or as a predictor of breast cancer.

      Key Words

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