Correlation Between Ultrasonographic Signs With Molecular-biology Markers&Pathology Of Infiltrating Ductal Breast Cancer

Objective:The relationship between the sonographic manifestations andhistopathological grading of breast invasive ductal carcinoma (IDC), human epidermalgrowth factor receptor2(Her-2) expression was analyzed retrospectively.Investigate theeffect of pathology and biological characteristics of malignant tumors of the IDC onultrasonographic signs in order to improve the efficacy of the ultrasonic imaging techniqueson the diagnosis of breast cancer, and to provide the basis for the choice of surgicalapproach,postoperative radiotherapy and chemotherapy and prognostic evaluation.Methods:86cases of IDC patients were taken preoperative ultrasound examination toobserve two-dimensional image features of the mass. CDFI was applied to observed tumorblood supply,using the Adler classification for grading of blood supply.the poor bloodsupply group conclude Class0and Class I.the rich blood supply group concludeClass II and Class III. All the patients were female，with no other history of malignancy; firstonset and unilateral，all the tumor were undergone ultrasound examination1week before thesurgery, tested by molecular biological markers of Her-2; and confirmed by pathology;postoperative inspected lymph nodes. all the image data was complete lesionsultrasonography at least4. Pages of ultrasound image were kept. Compare the ultrasoundresults with pathological grade and immunohistochemical results of Her-2.Compare axillarylymphatic metastasis under ultrasound with confirmed pathological axillary lymphaticmetastasis.All the data were managed by SPSS17.0software. The differences had statisticalsignificance(P<0.05).Results:1、The performance of two-dimensional ultrasound of IDC:, there were irregular shapein78cases (90.7%), internal low echo in86cases(100%)，unclear boundary and spiculesigns in cases （73.3%）homogeneous internal echo in69cases (80%), tumor size>2cm in54cases（62.8%）, rear echo attenuation in53cases (84.1%)., aspect ratio>1in18cases(20.9%),,rear attenuation in21cases（24.4%）, calcification in52cases（60.5%）,axillary lymphatic metastasis in52cases（60.5%）. 2、CDFI: grading by Alder: of7cases of stage0,30cases of stage1,27cases of stage2,22cases of stage30and1divided the blood supply rich,2and3for blood rich group,with a rich blood group of49cases, accounting for57%, poor blood group of37cases,accounting for43%.3、The number of Her-2positive cases is46，accounting for53.3%.4、Pathological grading：Class1in3cases（3.5%），Class2in65cases（75.6%），Class3in18cases（20.9%）.5、Axillary lymphatic metastasis in53cases(61.6%),none axillary lymphaticmetastasis in33cases(38.4%).6、Compare IDC ultrasonography with pathological grade, Immunohistochemicalresults of Her-2:(1) There is no statistical significance between ultrasound tumor diameter size, aspectratio, rear attenuation, calcification and lymph node metastasis at Armpit with pathologicalgrade, Her-2expression (P>0.05).(2) The difference of spicule sign between pathological grade1,2and3has statisticalsignificance (P <0.05).(3) The difference of spicule sign and Her-2expression pathological grade1,2and3has statistical significance (P <0.05).IDC ultrasound spiculation of Her-2expression wasstatistically significant (P <0.05).(4) Axillary lymphatic metastasis under ultrasound has correlation with axillarylymphatic metastasis pathological and its has statistical significance, the sensitivity ofultrasound diagnosis of metastatic axillary lymph nodes is84.9%and a specificity of78.8%.The conclusions:the sonographic manifestations of breast invasive ductal carcinomahas correlation with the pathological grade and the expression of prognostic indicators, somemarginal spiculation in the IDC ultrasonography can predict the level of Her-2andpathological grade in some degree, and ultrasound is higher accuracy of finding axillarylymph node metastasis.