Contrast-enhanced Spectral Mammography Findings In Breast Cancer Of Different Molecular Types

Background :Breast Cancer is now the leading cancer burden on women worldwide.At present,invasive biopsy or surgery is the main method to obtain tumor cells to further classify the different molecular types of breast cancer.Clinical hope to use non-invasive imaging methods to predict the molecular classification of breast cancer.Contrast-enhanced spectral mammography(CESM)is a new technique,which is comparable to MRI in diagnostic accuracy,but it has not been widely used in clinic.Recent studies have shown that CESM has the potential to predict the molecular typing of breast cancer.The purpose of this study was to investigate the correlation between imaging findings and molecular typing in CESM,and to summarize the imaging features of different molecular subtypes of breast cancer.Materials and methods:A total of 153 patients with invasive breast cancer confirmed by pathology after CESM examination in our hospital were collected and analyzed retrospectively.According to the results of immunohistochemistry,the data were divided into Luminal a,Luminal B,HER2 overexpression,basal-like(also called triple negative).According to the corresponding imaging reporting guidelines,the imaging features and enhancement data describing the lesions were recorded on the low-energy and subtraction images respectively.The enhancement curve and early enhancement degree were calculated based on the enhancement data.Finally,the imaging characteristics of CESM were analyzed and compared among different molecular subtypes.Results:There were significant differences in tumor shape,margin,lobulation,Burr,suspicious calcification,enhancement pattern and internal enhancement among different molecular types of breast cancer(P < 0.05).There was no significant difference in the early enhancement degree and enhancement curve among different molecular subtypes(P > 0.05).Conclusion:The imaging findings of breast cancer with different molecular classification on CESM were characteristic.The basic pathological changes,shape,marginal features,lobulation and spiculation,suspicious calcification,enhancement pattern and internal characteristics of enhancement were related to molecular typing in CESM.