Abstract
Context: Assessment of individual sonographic features provides vital clues about the biological
behavior of breast masses and can assist in determining histological grade of malignancy
and thereby prognosis. Aims: Assessment of individual sonographic features of biopsy proven invasive ductal breast
carcinomas as predictors of malignancy grade. Settings and Design: A retrospective analysis of sonographic findings of 103 biopsy proven invasive ductal
breast carcinomas. Materials and Methods: Tumor characteristics on gray-scale ultrasound and color flow were assessed using
American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS)
Atlas Fifth Edition. The sonographic findings of masses were individually correlated
with their histopathologic grades. Statistical Analysis Used: Chi square test, ordinal
regression, and Goodman and Kruskal tau test. Results: Breast mass showing reversal/lack of diastolic flow has a high probability of belonging
to histological high grade tumor (β 1.566, P 0.0001). The masses with abrupt interface boundary are more likely grade 3 (β 1.524, P 0.001) in comparison to masses with echogenic halos. The suspicious calcifications
present in and outside the mass is a finding associated with histologically high grade
tumors. The invasive ductal carcinomas (IDCs) with complex solid and cystic echotexture
are more likely to be of high histological grade (β 1.146, P 0.04) as compared to masses with hypoechoic echotexture. Conclusions: Certain ultrasound features are associated with tumor grade on histopathology. If
the radiologist is cognizant of these sonographic features, ultrasound can be a potent
modality for predicting histopathological grade of IDCs of the breast, especially
in settings where advanced tests such as receptor and molecular analyses are limited.
Keywords
BI-RADS - breast malignancy - histological grade - invasive ductal carcinoma - ultrasound
