The Study On The Reassessment Of Blood Flow In Breast Cancer And The Correlation Between BI-RADS Ultrasonic Signs Of Breast Cancer And Its Immunohistochemical Subtype

ObjectiveThe aims of this study were to study the difference of the blood flow between benign and malignant breast lesion,and to explore the influence of the age of patients,breast lesion size,lesion depth anterior to the lesion and breast thickness at the lesion location on the detection of the blood flow in breast cancer,and to evaluate the correlation between different molecular subtypes of breast cancer and its ultrasonic features according to the Breast Imaging Reporting and Data System(BI-RADS).MethodsUsing prospective analysis,152 cases of breast lesions were collected by high frequency color Doppler ultrasound in our hospital from January 2017 to March 2018,and they were divided into 76 cases of breast cancer(experimental group)and 76 cases of benign breast lesion(control group)according to the pathological findings.The differences in blood flow signals,blood flow distribution and resistance index(RI)between breast cancer group and benign breast lesion group were analysed;Measured the lesion depth anterior to the lesion and breast thickness at the lesion location,futher explored the influence of the age of patients,breast lesion size,lesion depth anterior to the lesion and breast thickness at the lesion location on the detection of the blood flow in breast cancer;Ultrasonic features of 76 cases of breast cancer were described according to the 5th edition of the ACR Breast Imaging Reporting and Data System(BI-RADS)US lexion,and they were divided into Luminal type and non-Luminal type breast cancer according to the immunohistochemical findings,including estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor 2(HER2),and Ki67,the correlation between different molecular subtypes of breast cancer and its ultrasonic features were studied.Results1.Compared with benign breast lesion,there were significant differences in blood flow signals,blood flow distribution,and resistance index of breast cancer(P<0.05).Breast cancer mostly presented with grade II~III,internal blood flow and RI?0.7,while benign breast lesion mostly presented with grade 0~I of blood flow and RI<0.7.2.There was a positive correlation between the detection of blood flow in breast cancer on color Doppler ultrasound and the lesion size,the difference was statistically significant(P<0.05).However,no significant difference was found in the correlation between the age of breast cancer patients,lesion depth anterior to the lesion or breast thickness at the lesion location and the detection of blood flow in breast cancer on color Doppler ultrasound(P>0.05).3.Compared with small breast cancer(?1cm),the distribution of blood flow and resistance index of breast cancer(>1cm)were significant different(P<0.05),breast cancer(>1cm)tended to present internal blood flow and RI?0.7.4.Compared with non-Luminal breast cancer,no statistical difference was found in pathological type distribution of Luminal breast cancer(P>0.05).5.Luminal breast cancer showed significantly smaller size,spiculated margin,and less abnormal lymph node on ultrasound when compared with non-Luminal breast cancer(P<0.05);Compared with non-Luminal breast cancer,there were no significant differences in the ultrasonic features of Luminal breast cancer including morphology,orientation,internal echo,posterior features,calcification and blood flow signals(P>0.05).6.The lesion diameter and abnormal lymph node of breast lesion on ultrasound were negatively correlated with Luminal tumor,while spiculated margin of breast lesion on ultrasound was positively correlated with Luminal tumor,the differences were statistically significant when compared with non-Luminal breast cancer(P<0.05).Conclusion1.There are significant differences in the blood flow signals,blood flow distribution and resistance index between breast cancer and benign breast lesion.Breast cancer is characterized by grade II ~ III of blood flow signals,internal and high resistant blood flow,while breast benign lesion is characterized by grade 0~I of blood flow signals and non-high resistant blood flow.High frequency color Doppler ultrasound plays an important role in the diagnosis and differential diagnosis of breast tumors.2.There is a positive correlation between the detection of blood flow of breast cancer on color Doppler ultrasound and the lesion size.The bigger the lesion is,the more obvious the blood flow characteristics are.3.Ultrasonic features show a smaller lesion,spiculated margin,and without abnormal lymph node,which has a predictive effect on Luminal breast cancer;While ultrasonic features show a larger lesion,abnormal lymph node,and without spiculated margin,which has a predictive effect on non-Luminal breast cancer.