The Value Of Combined Application Of Ultrasound And Ultrasonic Elastography In Diagnosing Breast Tumors

BackgroundAs women in economy, culture and living standard, the constant improvement of the social status and change in lifestyle, the speeding up of the pace of urbanization, the incidence of mammary gland disease increased year by year, especially the breast malignant tumor, it is the most common type of breast cancer. Breast ductal epithelium and epithelial happen at the end of the malignant tumor, is a common malignant tumors harm to women’s health, the cause has not yet fully understood. Breast cancer incidence and mortality were higher in our country, and the incidence of rising year by year, and the onset of younger age trend; Several studies have shown that breast cancer screening and early diagnosis, is of great significance to improve breast cancer survival rates and reduce mortality. Conventional ultrasound and high efficiency, simple operation, good repeatability and follow-up convenience, easy for patients to accept; Hardness of breast ultrasound elasticity imaging can provide lesions information, visible indirect judgment of benign and malignant tumors.ObjectiveTo investigate the diagnostic value of two-dimensional ultrasound combined with ultrasound elastography (UE) in breast lumps by observing ultrasound features and measuring UE scores of breast lumps. To analyze the correlation between ultrasound features and the expression of molecular biological markers ER and HER-2 of breast cancer and to analyze the correlation among ultrasound findings, UE scores and histological grades and types. So that to provide a reliable imaging basis for clinical use and to enhance the value of ultrasound in the diagnosis and treatment of breast cancer.Methods313 patients with 431 breast lumps from December 2013 to November 2014 in the central hospital of Zhumadian city were included in this study, pathological results were obtained from all patients either by surgery or by puncture. Preoperative ultrasound was performed in all patients who did not undergo previous radiotherapy and chemotherapy treatment. All data were collected on ultrasound findings, UE score, histological findings and the expression of ER, HER-2. The sensitivity, specificity and accuracy of ultrasound combining UE were assessed in diagnosing breast tumor. The relationship was investigated between UE scores and histological types of breast cancer, between ultrasound findings and the expression of ER and HER-2. All data was input with Microsoft Office Excel 2007 and analyzed by SPSS 17.0.x2 or Wilcoxon signed-rank test were used, α=0.05 was considered statistically significant.Results:1. Of 431 lesions,278 were benign,153 were malignant.2. No significant difference was found between the sensitivity, specificity and accuracy of conventional ultrasound and those of UE. By combination of general ultrasound and ultrasound elastography, however, the sensitivity, specificity and accuracy of conventional ultrasound combining UE were significantly higher than both conventional ultrasound and UE.3. There were no significant correlation between UE scores (from 1 to 5) and histological findings.4. The expression of ER is higher in the group with burr edge of breast tumor, but lower in the group with rich blood supply of tumor and the group with lymph node metastasis. The expression of ER has no correlation with tumor size and shape.5. The expression of HER-2 is higher in the group with rich blood supply of tumor and the group with lymph node metastasis, but lower in the group with burr edge of breast tumor. The expression of HER-2 has no correlation with tumor size and shape.6. There was a negative correlation between the expression of ER and HER-2 in breast cancer.Conclusion:1. Both conventional ultrasound and UE are useful in differentiating malignant from benign breast lumps, however, the combination of ultrasound and UE can improve the diagnostic accuracy and specificity.2. The ultrasound findings can reflect the histological results of breast tumor and has correlation with the expression of molecular biology markers, therefore, ultrasound findings can predict the prognosis of breast cancer to some extent, and provide an imaging basis for the selection of treatment options.