The Application Of Ultrasonography In The Diagnosis Of Ductal Carcinoma In Situ

Objective Compareing the ultrasonographic features of ductal carcinoma in situ,benignbreast tumor and invasive breast cancer,and searching nvestigation in situ ultrasonographic features of breast ductal carcinoma and its correlation with pathology.Methods Taking 137 cases of patients with BI-RADS 4 from February 2015 to May 2016 in breast surgery department of Yantai Yuhuangding Hospital by ultrasound examination method as research object.The ultrasonographic features of each lesions were recorded by gray scale ultrasound,such as size,shape,boundary,internal echo,posterior echo,calcification,and dilatation of the breast catheter.Color doppler flow imaging(CDFI)was used to observe the internal and peripheral blood perfusion.The blood supply was graded according to Adler quantitative classification,measure the arterial resistance index(RI).Examine the of immunohistochemical assay detect estrogen receptor(ER),progesterone receptor(Pr),human epidermal growth factor receptor(HER-2)in ductal carcinoma in situ.Studying the correlation between ultrasonography and pathological grading,ER,PR,HER-2 in breast ductal carcinoma in situ.Results The shape of lesions,internal echo,microcalcification,artery resistance index(RI)were statistically difference between DCIS and breast benign lesions(P=0.006,P=0.000,P=0.004,P=0.003).The aspect ratio,boundary of lesions,posterior echo attenuation,duct ectasia were not statistically difference between DCIS and breast benign lesions(P=0.117,P=0.684,P=0.534,P=0.141).The aspect ratio,boundary of lesions,duct ectasia,rear echo attenuation,blood flow signals were statistically difference between DCIS and breast invasive carcinoma(P=0.021,P=0.014,P=0.036,P=0.022,P=0.001).The shape of lesions,internal echo,microcalcification,artery resistance index(RI)were not statistically difference between DCIS and breast invasive carcinoma(P=0.061,P=0.391,P=0.150,P=0.675).The ultrasnographic features of breast ductal carcinoma can be divided into microcalcification group and non calcification group.The proportion of high grade ductal carcinoma in situ in microcalcification group was significantly more than that in non calcification group,and the difference was statistically significant(P=0.034,P=0.000).The negative expression of ER and PR and the positive expression of HER-2 in the microcalcification group were significantly higher than those in the non calcified group,which was statistically significant(P=0.040,P=0.025,P=0.047).Conclusion The features of ductal carcinoma in situ have the common characteristics of invasive breast cancer,irregular masses,microcalcification and high resistance index,but it lacks features such as spicule sign,crab foot syndrome,and rich blood flow in invasive breast cancer.Microcalcification in ductal carcinoma in situ is correlated with pathological grading,ER,PR and HER-2.