Value of Histogram of Gray-Scale Ultrasound Image in Differential Diagnosis of Small Triple Negative Breast Invasive Ductal Carcinoma and Fibroadenoma

Abstract

Objective To investigate the value of gray-scale ultrasound (US) image histogram in the differential diagnosis between small (≤2.00 cm), oval, or round triple negative breast invasive ductal carcinoma (TN-IDC) and fibroadenoma (FA). Methods Fifty-five cases of triple negative breast invasive ductal carcinoma (TN-IDC group) and 57 cases of breast fibroadenoma (FA group) confirmed by pathology in Hubei cancer hospital from September 2017 to September 2021 were analyzed retrospectively. The gray-scale US images were analyzed by histogram analysis method, from which some parameters (including mean, variance, skewness, kurtosis and 1st, 10th, 50th, 90th and 99th percentile) can be obtained. Intraclass correlation coefficient (ICC) was used to evaluate the inter observer reliability of histogram parameters. Histogram parameters between the TN-IDC and FA groups were compared using independent Student’s t -test or Mann-Whitney U -test, respectively. In addition, the receiver operating characteristic (ROC) curve analysis was used for the significant parameters to calculate the differential diagnosis efficiency. Results All the histogram parameters showed excellent inter-reader consistency, with the ICC values ranged from 0.883 to 0.999. The mean value, 1st, 10th, 50th, 90th and 99th percentiles of TN-IDC group were significantly lower than those of FA group (P < 0.05). The area under ROC curve (AUC) values of mean and n percentiles were from 0.807 to 0.848. However, there were no significant differences in variance, skewness and kurtosis between the two groups (P > 0.05). Conclusion Histogram analysis of gray-scale US images can well distinguish small, oval, or round TN-IDC from FA.

Preoperative prediction of lymphovascular invasion in patients with T1 breast invasive ductal carcinoma based on radiomics nomogram using grayscale ultrasound

“…Nottingham combined histological grading system was used to determine the histological grade ( 26 ). The expression levels of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), and Ki-67 antigen were measured through Immunohistochemical (IHC) analyses ( 16 , 26 ). ≤1% of carcinoma nuclei with positive staining indicated that ER and PR were negative ( 16 , 24 , 26 ).…”

“…Previous studies have demonstrated that preoperative breast mammography, digital breast tomosynthesis (DBT) or MRI can be effectively used for the prediction of LVI ( 1 , 3 , 6 , 7 , 15 ). Different from other imaging methods, US has the advantages of relatively low price, real-time, and reproducible operation, and is a reliable examination method for breast tumors in clinical work ( 16 ). Some CUS features had been demonstrated as the independent variables for predicting the presence of LVI in invasive breast cancer ( 8 ).…”

“…Moreover, multiparametric ultrasound, especially contrast-enhanced ultrasound (CEUS), could also provide good discriminative value for predicting LVI ( 12 ). However, the cost of additional contrast-enhancement is higher and the examination time is longer ( 16 ). Additionally, the assessment of CUS features and the quantitative indicators of CEUS may be susceptible to subjective factors ( 12 , 16 ).…”

“…However, the cost of additional contrast-enhancement is higher and the examination time is longer ( 16 ). Additionally, the assessment of CUS features and the quantitative indicators of CEUS may be susceptible to subjective factors ( 12 , 16 ).…”

“…At present, due to the improvement of people’s health consciousness and the increase of breast cancer screening, the diagnosis rate of T1 breast cancer has increased ( 16 , 23 ), in which the most common histological type is invasive ductal carcinoma (IDC) ( 16 ). Thus, the purpose of our study was to investigate whether a nomogram based on radiomics analysis of US imaging could predict the status of LVI in patients with pathologically confirmed T1 (pT1) IDC.…”