Analysis Of The Relationship Between Ultrasound Characteristics And Molecular Typing Of Breast Invasive Ductal Carcinoma And Carcinoma In Situ

Objective This study was to retrospectively analyze the relationship between color Doppler ultrasonography and pathological features of breast cancer and invasive carcinomas of different molecular subtypes in order to explore a more convenient and effective method for the diagnosis and treatment of breast cancer.Method 1 This study collected 185 patients who had undergone invasive surgery in our hospital with full ultrasound images,surgical data,and postoperative pathological diagnosis of breast cancer from August 2015 to July 2016.ER,PR and HER2 immunohistochemistry were routinely performed after surgery,which were divided into four molecular subtypes according to the 2013 St.Gallen International Breast Cancer Congress expert consensus.Luminal A-like,Luminal B-like,HER-2 over-expressed,and triple negative(referred to as TN in this study).)breast cancer,in which the Luminal A-like and Luminal B-like types have similar biological characteristics,was defined as a Luminal type in this study.2.All ultrasound data were independently analyzed by two senior sonographers without known of postoperative pathology,and consultations were conducted in case of disagreement.In this study,color Doppler features were described by the Ultrasound Image Dictionary of Breast Imaging and Date System(BI-RADS)developed by the American Radiological Association in 2013.Including size,shape,edge,internal micro-calcification,blood flow classification,lymph node metastasis,ultrasound elastography and histological grade.3.Immunohistochemical staining(IHC)and fluorescence in situ hybridization(FISH)were used to determine the expression of ER,PR,HER-2,and Ki-67 in breast cancer tissues.Molecular typing of breast cancer was also done.4.According to the degree of glandular duct formation in breast cancer,the pleomorphism of the nucleus and the number of mitotic counts,breast cancer was divided into three levels: grade I(low grade,high grade),grade II(moderate grade,medium grade),grade III(highly malignant,poorly differentiated).5.The c2 test was used to compare the color Doppler signs(based on BI-RADS classification)and the histological grading of the 4 types of molecular classification of invasive breast cancer and carcinoma in situ.Test level a=0.05,P <0.05 was considered statistically significant between the groups.Result(1)Of the 91 invasive ductal carcinomas,67 were Luminal(53.6%),20 were HER-2 overexpressed(22.0%),and 4 were negative(4.4%);94 were breast cancer in situ,Luminal 58 cases(46.4%)were like type,28 cases(29.8%)were HER-2 overexpression type,and 8 cases(8.5%)were triple negative.(2)Among the different molecular classifications of breast carcinoma in situ,the ultrasound signs: morphology,margin,azimuth,and posterior echo were all statistically significant(P<0.05).Whether microcalcification,blood flow classification,elasticity score,combined with microinvasion and presence or absence of The spatial effect was not statistically different(P>0.05);the Luminal type was compared with the TN type: the Luminal type was irregular in shape,the posterior echo showed no change,and the elasticity score was often higher than that of the TN type.The TN type often showed morphological rules.The posterior echo often showed enhancement(P<0.0167);HER-2 type and TN type: HER-2 type mostly showed vertical growth,and the edges were burr-shaped,while the TN type showed mostly parallel growth,edge finishing(P < 0.0167);there was no statistically significant difference between Luminal and HER-2.In the histological grade,the histological grade of the HER-2 type was often higher than that of the Luminal type(P<0.0167).(3)Among the different types of breast infiltrating ductal carcinoma,ultrasound signs: morphology,margin,azimuth,posterior echo,microcalcification,blood flow grade,and elasticity score were statistically significant(P<0.05),There was no statistical difference with lymph node metastasis.(P>0.05);Luminal-type and TN-type comparison: Luminal edge mostly burr,often vertical growth,TN edge is more smooth,parallel growth(P <0.0167);HER-2 type Compared with T-type: HER-2 type showed mostly edge angulation and burr,while TN-type edge was more smooth(P<0.0167);Luminal type and HER-2 type were compared: Cluster-like micro-particles inside HER-2 type lumps.Calcification and elasticity scores were often higher than Luminal(P < 0.0167).In the histological grade,the histological grade of the TN type was often higher than that of the Luminal type(P<0.0167).(4)The corresponding ultrasound features of invasive ductal breast cancer and carcinoma in situ showed statistically significant differences in tumor size,internal echo,peripheral hyper echo,posterior echo attenuation,and dilatation of the duct.Nodule aspect ratio,hypo echoic,inhomogeneous.There was no statistically significant differences in borderline,morphology,calcification,and blood flow signals.Conclusion 1.Ultrasound signs of breast carcinoma in situ and invasive ductal carcinoma have irregular morphology,borderline burrs,and vertical growth,which are more common in Luminal type breast cancer.Ultrasound features of TN type breast cancer often show morphological rules,relative marginal edges,and parallelism growth,in which diagnosis has a certain prompting effect.2.In breast carcinoma in situ,ultrasound signs: posterior echo enhancement and low elasticity score(?3)have a certain role in the diagnosis of TN breast cancer.3.In breast infiltrating ductal carcinoma,ultrasound signs: whether cluster-like micro-calcification and elasticity score(>3)within the mass have a certain role in the ultrasound diagnosis of Her-2 type breast cancer.4.The ultrasonographic features of Luminal breast cancer and triple-negative breast cancer can provide preliminary ultrasound information for molecular classification of breast cancer,which has certain significance in guiding clinical diagnosis and treatment.