Study Of Ultrasonographic Features And Clinical, Histopathological Characteristics Of Triple-Negative Breast Cancer

Objective?To investigate the clinical and histopathological characteristics of triple-negative breast cancer (TNBC),and further analyze the differences of ultrasonographic features between TNBC and non-TNBC, in order to improve the understanding and diagnostic level of radiologist to TNBC.Methods Collected the patients from January 2007 to February 2010 in First Affiliated? Hospital of Guangxi Medical University. All the patients were examined preoperatively with ultrasonography. Then, recorded the ultrasonographic features which involved the spiculations, rear echo, microcalcification, blood steam grade. All the patients proved by pathology with breast cancer. Breast cancer speciments were stained for ER, PR and HER-2 with immunohistochemical. Recorded the clinical and histopathological characteristics about the age of onset, the situation of menopause,the situation of axillary lymph metastases, pathological grades, pathologic types and the expression of P53. Divided the patients into 2 groups:TNBC and non-TNBC. The clinical, histopathological, ultrasonographic characteristics of TNBC patients were analyzed and comparaed with those of non-TNBC patients.Results①There were 52 TNBC among 318 patients(52/318,16.35%).②In TNBC group, the percentage of lymph node metastasis was 55.77%. And the rate was higher than that of non-TNBC group(P<0.05). There were no significant differences between the two groups in age, state of menstruation, symptom, pathological type, clinical stage and the expression of P53 (P>0.05).③In 318 cases, the lesions of 2 cases were not displayed by ultrasound. Among the other 316 patients, 192 masses were>2cm in diameter(60.76%); 129 masses with spiculations(40.82%); 76 masses were attenuated of the rear echo (42.72%); 135 masses with microcalcifications(42.72%); 208 masses were grade 2-3 of the blood stream(65.82%).④The percentage of cases which remained unclear diagnosis was higher in TNBC than the group of non-TNBC(P < 0.05).⑤In TNBC group, the percentage of spiculation, microcalcification and blood stream grade 2-3 were 23.08%, 28.85% and 51.92%. And the rates were lower than those of non-TNBC group(P<0.05). There were no significant differences between the two groups in size and rear echo of the breast tumor (P>0.05). Conclusion①The percentage of patients with TNBC is about 16% in all the cases.②TNBC patients have higher lymph node metastasis rate.③TNBC lacks typical features of the malignant tumor(spiculation, microcalcification and blood stream grade 2-3). It is difficult to distinguish TNBC from benign tumor. Breast radiologists should be cautious in diagnosis.