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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2018; 28(01): 123-131
DOI: 10.4103/ijri.IJRI_257_17
Breast Imaging

Sonographic features of invasive ductal breast carcinomas predictive of malignancy grade

Kanika Gupta
Departments of Radiodiagnosis, ESI Medical College and PGIMSR, Chennai, Tamil Nadu, India
,
Meenakshisundaram Kumaresan
Departments of Pathology, ESI Medical College and PGIMSR, Chennai, Tamil Nadu, India
,
Bhuvaneswari Venkatesan
Departments of Radiodiagnosis, ESI Medical College and PGIMSR, Chennai, Tamil Nadu, India
,
Tushar Chandra
Departments of Community Medicine, ESI Medical College and PGIMSR, Chennai, Tamil Nadu, India
,
Aruna Patil
Departments of Obstetrics and Gynecology, ESI Medical College and PGIMSR, Chennai, Tamil Nadu, India
,
Maya Menon
Department of Radiology, University of Central Florida, Orlando, USA
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Subject Editor: Financial support and sponsorship Nil.
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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


Publication History

Article published online:
26 July 2021

© 2018. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Osako T, Takahashi K, Iwase T, Iijima K, Miyagi Y, Nishimura S. et al. Diagnostic ultrasonography and mammography for invasive and noninvasive breast cancer in women aged 30 to 39 years. Breast Cancer 2007; 14: 229-33
    CrossrefPubMedGoogle Scholar
  • 2 McCavert M, O’Donnell ME, Aroori S, Badger SA, Sharif MA, Crothers JG. et al. Ultrasound is a useful adjunct to mammography in the assessment of breast tumours in all patients. Int J Clin Pract 2009; 63: 1589-94
    CrossrefPubMedGoogle Scholar
  • 3 Paulinelli RR, Freitas-Júnior R, Moreira MA, Moraes VA, Bernardes-Júnior JR, Vidal Cda S. et al. Risk of malignancy in solid breast nodules according to their sonographic features. J Ultrasound Med 2005; 24: 635-41
    CrossrefPubMedGoogle Scholar
  • 4 Costantini M, Belli P, Lombardi R, Franceschini G, Mulè A, Bonomo L. Characterization of solid breast masses: Use of the sonographic breast imaging reporting and data system lexicon. J Ultrasound Med 2006; 25: 649-59
    CrossrefPubMedGoogle Scholar
  • 5 Rao AA, Feneis J, Lalonde C, Ojeda-Fournier H. A Pictorial Review of Changes in the BI-RADS Fifth Edition. Radiographics 2016; 36: 623-39
    CrossrefPubMedGoogle Scholar
  • 6 Scarff RW, Torloni H. Histological typing of breast tumors. International histological classification of tumours. 2. World Health Organization; Geneva: 1968: 13-20
    Google Scholar
  • 7 Bloom HJ, Richardson WW. Histological grading and prognosis in breast cancer. Br J Cancer 1957; 11: 359-77
    CrossrefPubMedGoogle Scholar
  • 8 Levy L, Suissa M, Chiche JF, Teman G, Martin B. BIRADS ultrasonography. Eur J Radiol 2007; 61: 202-11
    CrossrefPubMedGoogle Scholar
  • 9 Aho M, Irshad A, Ackerman SJ, Lewis M, Leddy R, Pope TL. et al. Correlation of sonographic features of invasive ductal mammary carcinoma with age, tumor grade, and hormone-receptor status. J Clin Ultrasound 2013; 41: 10-7
    CrossrefPubMedGoogle Scholar
  • 10 Blaichman J, Marcus JC, Alsaadi T, El-Khoury M, Meterissian S, Mesurolle B. Sonographic appearance of invasive ductal carcinoma of the breast according to histologic grade. AJR Am J Roentgenol 2012; 199: W402-8
    CrossrefPubMedGoogle Scholar
  • 11 Kim SH, Seo BK, Lee J, Kim SJ, Cho KR, Lee KY. et al. Correlation of ultrasound findings with histology, tumor grade, and biological markers in breast cancer. Acta Oncol 2008; 47: 1531-8
    CrossrefPubMedGoogle Scholar
  • 12 del Cura JL, Elizagaray E, Zabala R, Legórburu A, Grande D. The use of unenhanced Doppler sonography in the evaluation of solid breast lesions. AJR Am J Roentgenol 2005; 184: 1788-94
    CrossrefPubMedGoogle Scholar
  • 13 Schroeder RJ, Bostanjoglo M, Rademaker J, Maeurer J, Felix R. Role of power Doppler techniques and ultrasound contrast enhancement in the differential diagnosis of focal breast lesions. Eur Radiol 2003; 13: 68-79
    CrossrefPubMedGoogle Scholar
  • 14 Stanzani D, Chala LF, Barros ND, Cerri GG, Chammas MC. Can Doppler or contrast-enhanced ultrasound analysis add diagnostically important information about the nature of breast lesions?. Clinics (Sao Paulo) 2014; 69: 87-92
    CrossrefPubMedGoogle Scholar
  • 15 Rotstein AH, Neerhut PK. Ultrasound characteristics of histologically proven grade 3 invasive ductal breast carcinoma. Australas Radiol 2005; 49: 476-9
    CrossrefPubMedGoogle Scholar
  • 16 Lamb PM, Perry NM, Vinnicombe SJ, Wells CA. Correlation between ultrasound characteristics, mammographic findings and histological grade in patients with invasive ductal carcinoma of the breast. Clin Radiol 2000; 55: 40-4
    CrossrefPubMedGoogle Scholar
  • 17 Costantini M, Belli P, Bufi E, Asunis AM, Ferra E, Bitti GT. Association between sonographic appearances of breast cancers and their histopathologic features and biomarkers. J Clin Ultrasound 2016; 44: 26-33
    CrossrefPubMedGoogle Scholar
  • 18 Irshad A, Leddy R, Pisano E, Baker N, Lewis M, Ackerman S. et al. Assessing the role of ultrasound in predicting the biological behavior of breast cancer. AJR Am J Roentgenol 2013; 200: 284-90
    CrossrefPubMedGoogle Scholar
  • 19 Elverici E, Zengin B, Nurdan Barca A, Didem Yilmaz P, Alimli A, Araz L. Interobserver and Intraobserver Agreement of Sonographic BIRADS Lexicon in the Assessment of Breast Masses. Iran J Radiol 2013; 10: 122-7
    CrossrefPubMedGoogle Scholar
  • 20 Kijima Y, Yoshinaka H, Koriyama C, Funasako Y, Natsugoe S, Aikou T. Ultrasound examination is useful for prediction of histologic type in invasive ductal carcinoma of the breast. Ultrasound Med Biol 2008; 34: 517-24
    CrossrefPubMedGoogle Scholar
  • 21 Horvath E, Cuitiño MJ, Pinochet MA, Sanhueza PS. Color Doppler in the study of the breast: How do we perform it?. Revista Chilena de Radiología 17
    Google Scholar
  • 22 Shin HJ, Kim HH, Huh MO, Kim MJ, Yi A, Kim H. et al. Correlation between mammographic and sonographic findings and prognostic factors in patients with node-negative invasive breast cancer. Br J Radiol 2011; 84: 19-30
    CrossrefPubMedGoogle Scholar