Correlation between mammographic and sonographic findings and prognostic factors in patients with node-negative invasive breast cancer

Abstract

Objectives: The purpose of this study was to correlate sonographic and mammographic findings with prognostic factors in patients with node-negative invasive breast cancer. Methods: Sonographic and mammographic findings in 710 consecutive patients (age range 21-81 years; mean age 49 years) with 715 node-negative invasive breast cancers were retrospectively evaluated. Pathology reports relating to tumour size, histological grade, lymphovascular invasion (LVI), extensive intraductal component (EIC), oestrogen receptor (ER) status and HER-2/neu status were reviewed and correlated with the imaging findings. Statistical analysis was performed using logistic regression analysis and intraclass correlation coefficient (ICC). Results: On mammography, non-spiculated masses with calcifications were associated with all poor prognostic factors: high histological grade, positive LVI, EIC, HER-2/neu status and negative ER. Other lesions were associated with none of these poor prognostic factors. Hyperdense masses on mammography, the presence of mixed echogenicity, posterior enhancement, calcifications in-or-out of masses and diffusely increased vascularity on sonography were associated with high histological grade and negative ER. Associated calcifications on both mammograms and sonograms were correlated with EIC and HER-2/neu overexpression. The ICC value for the disease extent was 0.60 on mammography and 0.70 on sonography. Conclusion: Several sonographic and mammographic features can have a prognostic value in the subsequent treatment of patients with node-negative invasive breast cancer. Radiologists should pay more attention to masses that are associated with calcifications because on both mammography and sonography associated calcifications were predictors of positive EIC and HER-2/neu overexpression.

The role of ultrasonographic findings to predict molecular subtype, histologic grade, and hormone receptor status of breast cancer

“…However, it is now widely known that many tumors may have variable posterior acoustic features; new studies have shown that well-defined margins and posterior enhancement are more likely to represent higher grade tumors and negative receptor status (13,15,16). Our results are consistent with these findings and there is a strong statistically significant correlation between these parameters.…”

“…Shin et al (16) showed that masses with circumscribed margins and posterior acoustic enhancement are associated with high grade and negative hormone status. In our study, similar to these results, tumors with circumscribed margins and posterior enhancement were more likely to be triple-negative, high grade, and hormone-receptor negative.…”

“…The posterior enhancement is seen more often in hormone receptor-negative HER2+ cancers (50%) than hormone receptor-positive HER2-cancers (29%) (16). Triple-negative tumors present with round, oval, and lobular shapes having an indistinct or microlobulated contour (19,20).…”

Mammographic and clinicopathological features of triple-negative breast cancer

“…[20][21][22]25 The broadly rounded shape of the masses can be explained by the rapid growth of these tumours that do not produce stromal reaction in breast cancer. 27 However, in contrast with this study and others, [20][21][22][23][24][25] Krizmanich-Conniff et al 26 reported that TNBC was mainly characterized by irregular masses (49%). Moreover, other studies 20,21,25,26 showed that the most common margins of tumour masses on mammography were indistinct (45-55%); however, in this study, the most common mass margins on mammography were circumscribed (37.2%), and less commonly mass margins were microlobulated (25.6%), which was consistent with the study reported by Dogan et al 22 Our results confirmed the findings of previous studies [20][21][22][23][24][25][26] that showed TNBC was less likely to have spiculated margins.…”

Imaging Features of HER2 Overexpression in Breast Cancer: A Systematic Review and Meta-analysis

“…Characteristics of studies reporting on mammography, breast ultrasound, MRI, and (17,18,70,87,91,(93)(94)(95)(96)(97)(98)(99)(100)(101)(102)(103)(104)(105)(106)(107). Of these, eight articles reported on two imaging modalities: five on both breast ultrasound and mammography (28,33,41,52,56), and three on both 18 F-FDG PET and DWI (70,87), or MRS (91). Table 1 shows the characteristics of the selected studies.…”