Analysis of X-ray signs and postoperative pathological features of breast cancer / 上海交通大学学报（医学版）

ABSTRACT

Objective • To investigate the relationship between the mammographic signs and the pathological features in breast cancer. Methods • From August 2015 to August 2018, 300 patients with primary breast cancer confirmed by operation and pathology in Shanghai First Maternity and Infant Hospital, Tongji University were selected. All patients had mammography before operation. The relation between characteristics of molybdenum target imaging and pathological types were retrospectively analyzed. The correlation between specific imaging signs such as lump, calcification, spiculation sign and important pathological features were further analyzed. Results • Among 300 cases of breast cancer, 251 cases (83.7%) had lumps, of which 183 cases had spiculation sign, and 190 cases had calcification. Besides, 235 cases (78.3%) had calcification; 77 cases (25.7%) had structural disorder with diffuse density; 98 cases (32.7%) had positive signs of vascular symptoms. Lump (95.1%), spiculation sign (82.3%) and calcification (83.7%) were mostly observed in invasive ductal carcinoma. Structural disorder (88.2%) was mostly observed in invasive lobular carcinoma. Calcification (96.1%) and lump (60.8%) were mostly observed in intraductal carcinoma. Calcification (100.0%) was mostly observed in lobular carcinoma in situ. Lump was mostly observed in simple carcinoma, medullary carcinoma and mucinous adenocarcinoma. The positive expression rates of estrogen receptor (ER) and progesterone receptor (PR) were higher in patients with tumor lump >5 cm than those with tumor lump ≤ 5 cm, but there were no significant differences (P=0.165, P=0.317). The positive rate of ER was 54.5% and the positive rate of PR was 60.8% in patients with calcification, which were lower than those without calcification (P=0.027, P=0.006). The positive rate of PR in patients with spiculation sign was 71.6%, which was higher than those without spiculation sign (P=0.018). But there was no significant difference in the expression of ER in patients with or without spiculation sign (P=0.321). Patients with lumps alone had a lower incidence of lymph node metastasis (29.5% vs 37.9%, P=0.009), and lower histological grade (P=0.043), in comparison with patients with lumps and calcification. But they had higher ER positive rate (70.5% vs 57.9%, P=0.033) and PR positive rate (73.8% vs 65.3%, P=0.014). Conclusion • Breast cancer patients with different pathological types show different signs of mammography which may have certain associations with the expression of immunohistochemical indicators such as ER and PR. Simple lump shadows in mammography may be a predictor in the good prognosis of breast cancer.