Application of three-dimensional ultrasound in the diagnosis of different molecular subtypes of breast cancer / 中华超声影像学杂志

ABSTRACT

Objective:To explore the value of three-dimensional ultrasound in differential diagnosis of different molecular subtypes of breast cancer.Methods:One hundred and twenty patients from August 2017 to December 2018 in the Second Affiliated Hospital of Harbin Medical University with breast masses were selected, and a total of 120 breast lesions were confirmed to be malignant by postoperative pathology. All patients underwent routine ultrasound and three-dimensional ultrasound before surgery. According to the St.Gallen criteria, the selected cases were divided into tubes according to the expression of immunohistochemical markers estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2). The Luminal epithelial subtype (Luminal subtype), HER-2 overexpression subtype and the triple negative subtype(TN subtype) were used to analyze whether there were differences in the three-dimensional ultrasound characteristics among different molecular subtypes of breast cancer.Results:①Three-dimensional gray-scale ultrasound Luminal subtype breast cancer often showed as an irregular shape of the mass, with burrs on the edges, differential leaves, high echo echoes around and coronal surface convergence. The HER-2 overexpression subtype masses were blurred, with angles, uneven internal echo, and often accompanied by microcalcification. The TN subtype were more clearly mass with more regular edge, slightly enhanced posterior echo. And the differences between the 3 groups were statistically significant ( P<0.05). ②Three-dimensional power Doppler The mean gray (MG), mean power (MP), ratio(R) and vascularization flow index (VFI) of three-dimensional ultrasonic flow volume in breast cancer with different molecular subtypes showed statistically significant differences (all P<0.05). There were significant differences of MG, MP between HER-2 overexpression subtype and TN subtype (all P<0.05). There were significant differences of R and VFI between HER-2 overexpression subtype and Luminal subtype, HER-2 overexpression subtype and TN subtype (all P<0.05). MG, MP, R, VFI values were the lowest in TN subtype and highest in HER-2 over expression subtype. ③Luminal subtype, HER-2 overexpression subtype, TN subtype blood flow grading and blood flow distribution were not significant different ( P>0.05). Conclusions:Three-dimensional ultrasound imaging combined with two-dimensional ultrasound can better reflect the morphological, blood supply and characteristics of different molecular subtypes of breast cancer, and provide more evidence for the diagnosis and identification of breast cancer before surgery.