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Objective:To explore the predictive value of various specific sonographic features on molecular subtypes for invasive breast carcinoma(IBC).Methods:Sonographic and clinicopathological data were retrospectively reviewed for 500 IBC patients who accepted surgical therapy in Fudan University Shanghai Cancer Center from January 2014 to March 2016. All tumors were divided into 5 molecular subtypes. The relationships of sonographic variations associated with the molecular subtypes for IBC were analyzed by univariate and multivariate Logsitic regression analyses.Results:Specific sonographic features for triple-negative subtype included regular shape ( OR=2.06, P=0.018), no spiculated/angular margin ( OR=1.98, P=0.029), posterior acoustic enhancement ( OR=2.26, P=0.005), and no calcification ( OR=2.13, P=0.006). Specific sonographic feature for human epidermal growth factor receptor-2 positive (HER2) subtype was posterior acoustic enhancement ( OR=2.23, P=0.006). Specific sonographic features for Luminal A subtype included spiculated/angular margin ( OR=2.24, P=0.001), posterior acoustic shadow ( OR=1.84, P=0.026), and no calcification ( OR=1.89, P=0.016). There were no specific sonographic features for the Luminal B with HER2 negative subtype, while that for the Luminal B with HER2 positive subtype was calcification ( OR=3.61, P<0.001). However, when used these sonographic features to predict molecular subtypes of breast cancer, the sensitivity values were 8.4%-57.3%, and positive predictive values were 9.5%-53.3%. Conclusions:The variety of sonographic features is associated with molecular subtypes of IBC.However, due to the overlap of sonographic features between different subtypes, molecular subtypes of IBC cannot be predicted by sonographic features.
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Objective To evaluate the association between quantitative ultrasonographic features and clinical ,pathological and immunohistochemical features of triple negative invasive breast carcinoma( TNBC) . Methods With the ethical approval , 96 patients who were pathologically confirmed as TNBC were retrospectively reviewed . All patients were sub-grouped according to age ,tumor size ,pathological grade , Ki67 expression level and human epidermal growth factor receptor 2 ( HER-2) score .Ultrasound images were segmented for the breast carcinoma mass using a phase-based active contour model . The high-throughput radiomics features were extracted based on the two-dimensional sonographic features . There were 460 features extracted from each ultrasound image . A series of computer aided algorithms including K-svd algorithm ,sparse representation ,support vector machine ( SVM ) and radial basis function were used to determine the high-throughput sonographic features that were highly correlated to clinical ,pathological and immunohistochemical features of TNBC . The performance efficacy was expressed by accuracy and area under curve ( AUC) of the ROC curve . Results The high-throughput ultrasonographic features of invasive TNBC could predict its pathological grade ,Ki67 level and HER-2 score with the accuracy 92 .2％ -96 .9％and AUC 98 .7％ -99 .9％ . There were 82 radiomics features selected for predicting the pathological grade of TNBC , the feature with the maximum weight was the elliptic-normalized eccentricity based on morphological features . There were 100 features selected for predicting the Ki67 expression level ,the feature with the maximum weight was the standard deviation of the annular region based on the boundary texture features . There were 85 features selected for the prediction of HER-2 score ,the most powerful parameter was the intensity based on NGTDM texture features . Conclusions Quantitative high-throughput ultrasonographic features are correlated with the pathological and immunohistochemical characteristics of invasive TNBC . High-throughput ultrasonographic features are valuable in predicting biological behavior of TNBC .
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Objective To investigate the clinical value of conventional ultrasonographic ( US),US-guided diffuse optical tomography ( US-guided DOT ) and both combined to assess treatment response of breast cancer to neoadjuvant chemotherapy( NAC). Methods Eighty-eight breast cancer patients,totally 93 lesions were included in the study. Pre-and post-last chemotherapy,size,and total hemoglobin concentration ( THC) of each lesion were measured by conventional US and US-guided DOT before biopsy,the change of lesion Size( ΔSize) and the change of THC( ΔTHC) were calculated respectively.Based on the guidelines to evaluate the response to treatment in solid tumors,the responses to NAC were classified into complete response, partial response, static disease, progressive disease groups. The histological response to chemotherapy were categorised as partial pathological response and complete pathological response using Miller and Payne system. Results Of 93 breast cancers,the overall response rate was 81.7%,the cPR rate was 24.7%. According to ROC curve analysis,when ΔSize 42.6% and ΔTHC 23.9% as cutoff values to evaluate the complete response and partial response,the area under the curve ( AUC ) were 0.666 and 0.751,respectively,the AUC of US and US-guided DOT combined in parallel and in series were 0.680 and 0.737 respectively.When ΔSize 64.5% and ΔTHC 27.2% as cutoff values to evaluate complete pathologial response,the AUC were 0.690 and 0.728 respectively,the AUC of US and US-guided DOT combined in parallel and in series were 0.693 and 0.726 respectively. Conclusions US-guided DOT and US can be used to predict breast cancers response to NAC,US and US-guided DOT combined in parallel and in series can not improve response prediction comparing with US or US-guided DOT alone.
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Objective To investigate the relationship of greyscale ultrasonographic signs and clinical pathological characteristics with axillary lymph node metastasis in invasive breast cancer.Methods Three hundred and thirty-five patients with pathologically confirmed breast cancer were retrospectively analyzed,which categorized into 2 groups,including lymph node metastasis group and lymph node non-metastasis group.The clinical and pathological characteristics included age,primary tumor size,histological grade,and molecular subtypes.The ultrasonographic features were examined including orientation,shape,margin,echo pattern,posterior acoustic feature,and calcification.Chi-Square test and Logistic regression analysis were performed to analyze the relationship of clinical pathological characteristics and greyscale ultrasonographic signs with axillary lymph node metastasis.Results Age (＜45 years),primary tumor size (≥2 cm),histological grade(Ⅲ grade),molecular subtype (Luminal B),and number of margin angulation (＞ 10) contributed to axillary lymph node metastasis in 335 cases,according to univariate analysis (P ＜0.05).Multivariate Logistic regression analysis showed age (OR =0.573,P =0.019),the primary tumor size (OR=2.359,P =0.001),histological grade (OR=0.529,P =0.008),and number of marginangulation (OR =1.889,P =0.031) were risk factors of axillary lymph node metastasis in breast cancer.Conclusions Univariate and multivariate analyses show the correlation between ultrasonographic features and axillary lymph node involvement.Combining with clinical pathological data,it can provide a predictor of axillary lymph node metastasis.
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Objective To investigate the value of ultrasound-guided diffuse optical tomography (US-guided DOT) to predict clinical efficacy of breast cancer neoadjuvant chemotherapy (NAC).Methods Eighty-eight breast cancer patients with 93 lesions were included.Pre-and post-last chemotherapy,the size,total hemoglobin concentration (THC) of each lesion were measured by ultrasonography (US) and US-guided DOT.Based on the guidelines to evaluate the response to treatment in solid tumors,the lesions of treated breast cancer patients were divided into 4 types of responses to NAC:complete response (CR),partial response (PR),stable disease (SD),and progressive disease (PD).Efficient groups include CR and PR groups.Results As expected,no significant difference was found in size and THC for untreated lesions (all P ＞0.05).However,for the treated lesions(P =0.001),THC,pre-vs post-treatment size changes (△Size％) (P =0.002) and THC changes (△THC％) (P ＜0.001) were significantly varied among CR,PR,SD,PD groups.When compared with pre-treated,tumor sizes after treatment were changed significantly in all CR(P ＜0.001),PR(P ＜0.001),SD (P =0.023) and PD (P =0.001),while significant change of THC was only found in CR(P ＜0.001),PR(P ＜0.001) and SD (P =0.002).When △THC％ =23.9％ as the threshold for prediction of NAC efficiency,the area under the curve of ROC was 0.75,and the sensitivity was 73.7％,specificity was 76.5 ％,positive predictive value was 93.3 ％,negative predictive value was 39.4％,accuracy was 74.2％.Conclusions △size％ changes in consistent with △THC％ among the intergroups,but their changes levels are different,the highest change percent appears in CR,gradually decreased in PR,SD groups.△THC％ will contribute to predict preoperative clinical NAC efficacy.