Research On The Correlation Between The Molecular Classification Of Breast Cancer And BI-RADS-US Signs

Research purposeTo explore the correlation of BI-RADS-US characteristics and the expression of ER,PgR,HER-2 and Ki67 and the molecular subtypes of breast cancer,so as to provide valuable imaging information for the early clinical diagnosis of breast cancer,the determination of individualized treatment scheme and the prognosis evaluation.To understand the complete biological characteristics of breast cancer and expand the application of ultrasound in the field of breast cancer.MethodsConduct a retrospective study on the ultrasonic imaging and clinical surgical pathology data of 216 patients with breast cancer.Record the tumor according to the BI-RAIDS-US Imaging Terminology Dictionary developed by ACR 2013,include tumor size,shape,orientation,margin,Internal echo,posterior echo,Calcifications,vascularity,Changes in the surrounding structure and organization,Lymph node metastasis.Based on the molecular typing criteria of breast cancer recommended by the St Gallen conference 2013,breast cancer is classified into five subtypes,that is luminalA-like,luminalB-like(HER-2 negative),lummalB-like(HER-2 positive),HER-2 overexpressed and triple-negative.Chi-square test was used to analyze the correlation between molecular biological indicators and molecular subtypes of breast cancer and BI-RADS-US signs.Results1.The incidence rates of the five molecular subtypes are 6.5%?47.2%?21.3%?10.2%?14.8%.There was no statistically significant difference in age distribution among subtypes(P>0.05).2.There was no significant difference in the distribution of Ki67 high expression among the four subtypes except luminalA-like(P>0.05).3.The positive expression of ER and PgR was correlated with margin spiculated sign,and negative expression was associated with margin circumscribed(P<0.05).The positive expression of Her-2 was associated with big lump,angular margin,internal cystic and solid mixed echo,calcification,and lymph node metastasis(P<0.05).The positive expression of Ki67 was related to the internal vascularity and lymph node metastasis,while the negative expression was associated with no vascularity(P<0.05).4.Tumor size,shape,margin,calcification and lymph node metastasis were significantly correlated with molecular subtypes,while tumor growth direction,internal echo,posterior echo,vascularity and surrounding structural changes were not associated.triple-negative type had the highest proportion of oval tumor,which was statistically significant compared with others(P<0.005).Triple-negative type with circumscribed and microlobulated margin had the highest occurrence rate,The HER-2 overexpression type has the highest incidence of angular margin,The occurrence rate of LA type of spiculated was the highest but the incidence of triple-negative was lowest,The absolute value of the adjusted normalized residuals was>2,which was significantly different from others.The proportion of calcification was the highest in the HER-2 overexpression and LB(HER2+)type,which was statistically significant compared with triple-negative type(P<0.005).LB(HER2+)and HER-2 overexpression type had the highest proportion of node metastases,and the difference was statistically significant compared with LA type and triple-negative(P<0.005).Conclusion1.The ultrasonographic signs of breast cancer are related to the expression of ER,PgR,HER-2 and Ki67,and the gene expression of breast cancer with different ultrasonographic characteristics are also different.2.Different molecular subtypes of breast cancer have different ultrasonic characteristics,among which LB(HER2+)and HER2+types have higher BI-RADS classification.