Ultrasonic Features Of Young Breast Cancer And Its Correlation With Molecular Subtypes

Objective:To explore the differences of clinicopathological features and ultrasonic features between the young(?35 years old)and middle or elder(>35 years old)with breast cancer.And to analyze the relationship between the ultrasound images and molecular subtypes in young breast cancer.Aim to early diagnose young breast cancer accurately and provide a reference for the selection treatment strategies and prognostic evaluation of young breast cancer.Methods:From January 2015 to December 2018,89 cases(93 lesions)of young breast cancer confirmed by suigical pathology were reviewed retrospectively,160 cases(167 lesions)of middle or elder patients with breast cancer selected as controls.To analyse the different features of clinicopathological and ultrasound images between young group and middle or elder group.According to ER,PR,HER-2,Ki-67 immunohistochemical results,which was divided into Luminal A and B type,HER-2 type and basal-like type in four groups.To explore if there is a different ultrasound features between different molecular subtypes in the young group.Results:1.Clinicopathological features:There were significant differences in tumor size,histological grades,lymph node metastasis,ER,HER-2,Ki-67,and molecular subtypes between the two groups(P<0.05).Compared with the middle or elder group,the younggroup had larger size,higher grade,lymph nodes positive,more ER negative,more HER-2 and Ki-67 positive,and more basal-like type.There were no significant differences in pathological type and PR expression.2.Ultrasonic features:There were significant differences in size,internal echo,calcification and posterior echo between the two groups(P<0.05).Compared with the middle or elder group,the young group had larger size,uneven internal echo,and more masses with calcification;the middle or elder group was more likely to have posterior echo attenuation than the young group.There were no significant differences in aspect ratio,morphology,border,margin,and blood flow(P>0.05).3.Relationship between ultrasound features and molecular subtypes in young groups:There were statistical differences in morphology,internal echo and calcification of different molecular subtypes in young group(P<0.05).There were no significant differences in size,aspect ratio,border,margin,posterior echo and blood flow(P>0.05).The basal-like group masses more showed regular shape,clear boundary,uniform internal echo and no calcification.The other three types were mainly characterized by irregular shape,unclear boundary,spiculated margin or crab feet and uneven internal echo.HER-2type and Luminal B type masses with calcification was higher than the other two types.The aspect ratio ?0.7 of HER-2 type was higher than other three types,but the difference was not statistically significant(P=0.457).Basal-type and HER-2 type masses blood flow were more abundant than Luminal type,but the difference was not statistically significant(P=0.364).Conclusion:1.The ultrasound images and clinicopathological features of young breast cancer were different from those of middle or elder people.2.There were some differences in ultrasound images of young breast cancer patients with different molecular subtypes.