Correlation Between Ultra-sonographic Signs With Molecular-biology Markers IDC And The Research On Application Of BI-RADS-US Classification In Breast Lesions

Diagnostic Value of Breast Imaging Reporting And Data Systemon Breast Diseases and the Correlation Between UltrasonographicSigns and Molecular-biology Markers of Breast CancerObjective：To research and analyze retrospectively the Accuracy,specificity and sensitivity of the diagnosis of breast cancer usingthe level3,4and5of Breast Imaging Reporting And Data System(BI-RADS). And to investigate the correlation between ultrasonographicsigns and some molecular-biology markers (Her-2,EGFR).Methods:1. We selected277cases of female patients who were diagnosedas level3,4and5of BI-RADS by ultrasonographic in the secondthe Hospital of Jilin University from Sep2011to Dec2012, and allof the breast tubercles were confirmed by Pathological findings. Then we compared the ultrasonographic results with pathologicalfindings, and analyzed the Accuracy, specificity and sensitivityof the diagnosis of breast cancer with BI-RADS by statistical method.2. Among the pathological findings,We analyzed the96cases ofpatients who were diagnosed as Breast Cancer and were detected themolecular-biology markers(Her-2, EGFR). Then we compared theultrasonographic results with molecular-biology markers. Aftertested withχ2and dealed with SPSS13.0, we found that they hadstatistical significance(P<0.05).Result：1. The sensitivity of ultrasonographic BI-RADS classificationin breast cancer diagnosis was96.2percent,and the rate of misseddiagnosis was3.8percent, the specificity was90.8percent, themisdiagnosis rate was7.2percent.2. Compared the ultrasonographic results of breast cancer withHer-2of immunohistochemical results of breast cancer: (1) The ultrasonographic results of breast cancer were rich bloodflow, spicule sign, tumor calcification and axillary fossalymphadenectasis, which had remarkable positive correlation withthe expression of Her-2(P<0.05).(2) There were no statistical significance differences between theultrasonographic results and the expression of Her-2in tumor size,aspect ratio and tumor shape of the breast cancer (P>0.05).3. Compared the ultrasonographic results of breast cancer withEGFR of immunohistochemical results of breast cancer:(1) The ultrasonographic results of breast cancer were rich bloodflow, spicule sign and tumor calcification, which had remarkablepositive correlation with the expression of EGFR(P<0.05).(2) There were no statistical significance differences betweenthe ultrasonographic results and the expression of EGFR in tumorsize, aspect ratio, tumor shape and the axillary fossalymphadenectasis of the breast cancer (P>0.05). 4．It had obvious correlation between the axillary lymph nodesmetastasis proved by ultrasonographic and pathological examination,and there was statistical significance difference between them. Thesensitivity of the diagnosis of axillary lymph nodes metastasis withultrasonographic was83.3percent,and the rate of missed diagnosiswas16.7percent, the specificity was78.2percent, the misdiagnosisrate was21.8percent.Conclusion:1.As a quality control method, BI-RADS classification not onlycan standardize breast lesions, but it also can provide a moreaccurate basis for the identification of breast tumors. BI-RADSclassification has widly use value and can provide a more reasonabletreatment plan for the clinician.2. Although BI-RADS classification can be relatively accurate,but there is still a certain rate of misdiagnosis. So our descriptionand diagnosis should be in strict accordance with the terms ofBI-RADS classification. Only in this way,we can reduce the diagnostic impact of subjective experience and improve thediagnostic accuracy.3. To some exten, the ultrasonographic signs of breast canpredict the biological activity of breast cancer and the expressionof Her-2and EGFR.The finding of the axillary lymph nodes metastasisby ultrasonographic plays an important role in breast surgicalapproachs and prognosis assessments.