Study On The Correlation Between Ultrasound Findings And Pathology Of Non-Mass Cancers On Breast

ObjectiveDue to its different periods and growth patterns,non-mass cancers on breast lack of typical imaging features.Therefore,the clinical detection rate is low,and the rate of misdiagnosis is high.This article uses pathological results as the gold standard to analyze the causes of misdiagnosis by analyzing the ultrasound characteristics of non-mass cancers on breast,aiming to improve the diagnosis of non-mass cancers on breast.MethodsA retrospective analysis of 187 patients who were admitted to our hospital from January 2015 to January 2019 was performed.Ultrasound findings in these patients showed no spatial space-occupying effect on two different scan sections,and surgical pathology confirmed breast cancer.Ultrasound imagings were divided into four types:hypoechoic area,ductal dilatation,microcalcification and architectural distortion.The pathological results were used as the gold standard to analyze the characteristics of different types of non-mass cancers on breast,and to find out the causes of ultrasound misdiagnosis.Results1.Among the ultrasound types of 187 non-mass cancers with a single lesion of unilateral breast,118 cases(63.0%)had hypoechoic area,28 cases(15.0%)had ductal dilatation,16 cases(8.6%)had microcalcification,and 25(13.4%)had architectural distortion.2.The pathological histology types were as follows:① ductal carcinoma in situ(86/187,46.0%),②ductal carcinoma in situ with microinvasion(27/187,14.4%),③invasive ductal carcinoma(71/187,30.0%),④invasive lobular carcinoma(3/187,1.6%)3.The histopathological types of non-mass cancers on breast with different ultrasound findings were as follows:there were only two histopathological types in 28 cases of ductal dilatation lesions,ductal carcinoma in situ and ductal carcinoma in situ with microinvasion respectively.The proportion of ductal carcinoma in situ was 96.4%(27/28),which was significantly higher than the other three pathological types(P<0.001).118 cases of hypoechoic area lesions were mainly invasive ductal carcinoma(57/118,48.3%),the proportion was higher than the other three pathological types(P=0.001).The histopathological types of 16 microcalcification lesions were ductal carcinoma in situ(8/16,50.0%),ductal carcinoma in situ with microinvasion(4/16,25.0%),invasive ductal carcinoma(4/16,25.0%)(P=0.808).The histopathological types of 25 architectural distortion lesions were ductal carcinoma in situ(8/25,32.0%),ductal carcinoma in situ with microinvasion(6/25,24.0%),invasive ductal carcinoma(10/25,40.0%),invasive lobular carcinoma(1/25,4.0%)(P=0.249).4.There were a total of 150 cases of ultrasound BI-RADS classification of 4 and above,the diagnostic accuracy rate was 84.0%(150/187).5.There were 30 cases of ultrasound BI-RADS classification in grade 2 or 3,and the misdiagnosis rate was 16.0%(30/187).Among them,ultrasound showed 4 cases of latex cysts,7 cases of ductal dilatation,10 cases of breast hyperplasia,4 cases of breast cystic hyperplasia,2 cases of intraductal papilloma,1 case of mastitis,and 2 cases of plasma cell mastitis.Conclusions1.The ultrasonographic features of non-mass cancers on breast are mainly hypoechoic areas,and the histopathological types are mainly ductal carcinoma in situ.2.BI-RADS grading standard makes ultrasound examination more standardized for qualitative diagnosis of non-mass cancers on breast,and it has high diagnostic efficiency.We hope to establish a recognized standard for the evaluation ofnon-mass cancers on breast by ultrasound BI-RADS in the future.3.Hypoechoic areas with blurred edges,ductal dilatation with or without solid components,distortion of local glandular architectures,and densely distributed microcalcifications may be ultrasound findings of non-mass cancers on breast,which should be adequately addressed by the sonographer to improve the diagnostic accuracy of non-mass cancers on breast.