Imaging Features Of Breast Space-occupying Lesion On Automated Breast Volume Scanner Coronal Plane And Its Clinicopathological Correlation

Part 1 Imaging features of breast space-occupying lesion on automated breast volume scanner coronal planeObjective To evaluate the value of automated breast volume scanner (ABVS) coronal plane (c-plane) in the differential diagnosis of benign and malignant breast space-occupying lesions.Materials and methods The ABVS c-plane images of 138 breast space-occupying lesions (85 benign lesions and 53 malignant lesions) in 130 women were retrospectively evaluated in our study from the following two aspects:the imaging features of lesion itself (lesion boundary, margin contour and capsule) and changes of surrounding tissue (no change, convergence symptom, hypoecho halo and hyperecho halo). Theχ2 test was used to compare c-plane features between benign and malignant breast lesions.Results1. Imaging features of invasive breast carcinoma, fibroadenoma and breast adenosis In ABVS c-plane, most invasive breast carcinoma showed indistinct boundary (39/53,73.6%), wormy appearance (38/53,71.7%), the absence of capsule (52/53, 98.1%) and convergence symptom (27/53,50.9%). The main features of fibroadenoma were abrupt interface (58/60,96.7%), smooth margin ((46/60,76.7%) and no changes of surrounding tissue (45/60,75.0%). Most breast adenosis demonstrated similar imaging features as fibroadenoma, which included clear abrupt interface (18/25,72.0%), smooth or lacked smooth margin (20/25,80.0%), and no changes of surrounding tissue (14/25,56.0%).2. The differential diagnosis between benign and malignant breast lesions(1) Wormy appearance, convergence symptom and the combination of them have a sensitivity of 71.7%,50.9% and 90.6%, respectively and a specificity of 98.8%, 97.6% and 97.6%, respectively. The areas under the ROC curve (AUC) of the three diagnostic indicators were 0.853,0.743 and 0.941, respectively.(2) The sensitivity, specificity, positive predictive value (PPV) and negative % predictive value (NPV) for wormy appearance to, differentiate breast adenosis with indistinct boundary from invasive breast carcinoma were 71.4%,98.1%, 83.3% and 96.3%.(3) The hypoecho halo has a sensitivity of 14.1% and a specificity of 100% for differentiating benign breast lesions from malignant ones.Conclusions ABVS c-plane can help to differentiate benign breast lesions from malignant ones.Part 2 Correlation between clinicopathological characteristics and convergence symptom in patients with breast infiltrating ductal carcinomaObjective To explore the value of convergence symptom in predicting the treatment sensitivity and the prognosis of patients with breast infiltrating ductal carcinoma (IDC).Materials and methods A retrospective review was performed in 46 women with 47 IDC lesions. Correlation between clinicopathological characteristics and convergence symptom was analyzed. Clinicopathological characteristics included tumor size, tumor grade, axillary lymph node state and the expression of ER, PR and HER2.Results There was no obvious difference within different IDC groups by tumor size or axillary lymph node state in the presentation of convergence symptom (P>0.05). The convergence symptom was more common in grade II IDC lesions than in grade III IDC lesions and the difference is statistically significant (P=0.01). No difference was found between the presentation of convergence symptom and the expression of ER (P=0.055). Significant correlations were found between the presentation of convergence symptom and the expression of PR and HER2 (P<0.05).Conclusions Convergence symptom is helpful in predicting the treatment sensitivity and the prognosis of patients with breast infiltrating ductal carcinoma.