Association Of Mammography,MRI With Molecular Subtypes Of Breast Cancer

Objective To observe the value of combination of mammography(MG).MRI and pathology for diagnosis of molecular subtypes of breast cancer.Methods In this study,1396 cases of breast cancer patients confirmed by pathology were retrospectively analyzed in XXX Medical University Hospital from January 2018 to December 2022.All patients underwent mammography and MRI examinations,and the interval did not exceed 45 days.According to the results of immunohistochemistry,1396 female patients with breast cancer were enrolled,including 338 cases of Luminal A type,651 cases of Luminal B type,171 cases of human epidermal growth factor receptor 2(HER 2)enriched type and 236 cases of triple negative type.MG,MRI and pathological features of different molecular subtypes of breast cancer were compared,and logistic regression analysis was performed to explore the independent impact factors of different molecular subtypes of breast cancer.Then pathology model(model 1),pathology + MG model(model 2),pathology+ MRI model(model 3)and pathology+ MG+ MRI model(model 4)were constructed.Determining the best predictive model for different molecular subtypes of breast cancer by the area under the ROC curve.SHAP was used to analyze the contribution value of each parameter in the best diagnostic model.Results Histological grade invasive ducal carcinoma,combined with DCIS,axillary lymph node metastasis,false negative MG,suspicious calcification and time-signal intensity curve(TIC)were independent impact factors of Luminal A breast cancer group(all P<0.05).Pathological type,axillary lymph node metastasis,suspicious calcification,spiculation,and apparent diffusion coefficient were the independent impact factors of Luminal B breast cancer type(all P<0.05).Histological grade invasive ductal carcinoma,suspicious calcification,spiculation,mass enhancement type and apparent diffusion coefficient were independent impact factors of HER 2 enriched breast cancer type(all P<0.05).Pathological types,histological grade invasive ductal carcinoma,suspicious calcification,mass enhancement type,spiculation and apparent diffusion coefficient were independent impact factors of tiple negative breast cancer type(all P<0.05).Model 2 was the best model for diagnosing Luminal A breast cancer type(the area under the curve [AUC]= 0.756),while model 4 was the best model for diagnosing Luminal B 、 HER-2 enriched and triple negative breast cancer type(AUC=0.653、0.741、0.780).According to SHAP analysis,combined DCIS,suspicious calcification,axillary lymph node status,and spiculation were of great value for diagnosis molecular subtypes of breast cancer.Conclusion The combined model of MG,MRI and pathology had certain value for diagnosing molecular subtypes of breast cancer.Combined DCIS,suspicious calcification,axillary lymph node status,and spiculation were of high diagnostic value.