Correlation of sonographic features of invasive ductal mammary carcinoma with age, tumor grade, and hormone‐receptor status

Abstract

Purpose To determine whether presenting sonographic features of invasive ductal carcinomas (IDC) are associated with patient age, tumor histologic grade, and hormonal receptor status. Methods Sonographic features of 101 consecutive cases of IDC seen at ultrasound were retrospectively assessed based on the BI-RADS criteria of posterior acoustic appearance, tumor margins, and echogenicity. Associations between sonographic features and tumor characteristics were statistically evaluated with attention to patient age. Results IDC with shadowing compared with unchanged posterior acoustic appearance were significantly more likely to be of low histologic grade (Odds Ratio [OR] = 5.00; p < 0.05) and estrogen receptor (ER) -positive (OR = 10.00; p < 0.05). Conversely, posterior enhancement was associated with ER-negative status (OR = 4.45; p < 0.01), particularly among patients younger than 60 years of age (OR = 5.36, p < 0.05). Circumscribed tumors were more often high grade, particularly among older women (p < 0.01), and hormone receptor--negative regardless of age group. Among older women, tumors with mixed echogenicity tended to be high grade and progesterone receptor--negative (p values < 0.05). Noncircumscribed borders were observed for all tumors with posterior shadowing, and 97% of such tumors were also ER positive. Conclusions Sonographic features were significantly associated with tumor grade and hormone receptor status, with some differences based on patient age. Specifically, the presence of posterior shadowing was associated with lower histologic grade and ER-positive status, especially in older patients. In contrast, we found that posterior acoustic enhancement was more commonly associated with ER-negative status, especially in younger patients.

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.…”

“…Previously, the majority of malignant breast tumors were expected to have posterior acoustic shadowing at US and have poorly defined spiculated margins (13,14). 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).…”

Combined Use of Ultrasound Elastography and B‐Mode Sonography for Differentiation of Benign and Malignant Circumscribed Breast Masses

“…It has been reported that, paradoxically, high-grade tumors were more likely to be well circumscribed. 14,17 High tumor stiffness values for breast malignancy might be particularly useful in high-grade cancers. [40][41][42] In this study, 16 of 98 benign masses were downgraded.…”

“…[11][12][13] Furthermore, a circumscribed margin on B-mode sonography was associated with a high histologic grade and an aggressive immunohistologic subtype. [14][15][16][17][18] Circumscribed breast cancers might be assigned to an inappropriate lower BI-RADS category on B-mode sonography, 9,19 leading to a delayed diagnosis.…”

Ultrasound Diagnosis of Breast Lymphoma and the Identification of Breast Infiltrating Ductal Carcinoma

“…In a clinical setting, breast US is highly sensitive, and the National Comprehensive Cancer Network has recommended this modality as the first‐choice imaging examination for mammary disease . As the US imaging characteristics of mammary lymphoma have many similarities to those of breast infiltrating ductal carcinoma (BIDC), misdiagnosis often occurs . However, the treatments of these diseases vary considerably.…”