The Relationship Between The Imaging Characteristics Of Digital Breast Tomosynthesis,Full-Field Digital Mammography,Ultrasound And Histological Grade Of Invasive Ductal Carcinoma

ObjectiveThis study aims at identifying the correlation between the image data obtained by DBT 、FFDM、Ultrasound and the histological grade of breast cancer;and providing a reference for predicting the histological grade of breast cancer in the subsequent diagnosis and treatment.MethodsA total of 270 female patients were enrolled in this study,who were diagnosed with invasive dunctal breast carcinoma(IDC)and treated at the Breast Surgery of China-Japan Friendship Hospital of Jilin University from July 2016 to July 2018.All patients had complete the preoperative examination(DBT,FFDM and Ultrasound).Postoperative resection tissue was sent for pathological examination with paraffin wax,and conformed as invasive dunctal breast carcinoma.In this retrospective study,FFDM image data were interpreted by 2 attending physicians with double-blind method,and DBT image data were added for film reading.The results were collected and recorded for statistical analysis,and relatively consistent results were obtained(Kappa > 0.70).The histologic grade of breast cancer was determined by histological grading method proposed by Elston and Ellis,which is the most commonly used clinically,namely determining the histological grade by observing the formation of glandular tubes,the count of mitotic phase,and the polymorphism of the nucleus.SPSS 22.0 statistical software was used for data processing to analyze whether the imaging data obtained from DBT 、FFDM、Ultrasound were related to Invasive ductal breast carcinoma of histological grade.ResultsThere were statistical differences in the three examination methods in the examination of lesions.DBT+FFDM and ultrasound were superior to FFDM in lesion detection and lesion boundary observation.In the examination of malignant calcification,DBT+FFDM and FFDM were superior to breast ultrasound.Ultrasoundwas superior to DBT+FFDM and FFDM in lymph node observation.Therefore,DBT+FFDM has better diagnostic efficacy than FFDM,and DBT+FFDM is similar to breast ultrasound in diagnostic efficacy.By DBT+FFDM,FFDM,and ultrasound,we found statistical differences in the size of the lesion,presence of burrs,fuzzy boundary,suspected metastasis of axillary lymph nodes,and rich blood supply in histological grade I vsII vsIII.(p < 0.05).DBT+FFDM and ultrasound can better predict histological grading.The larger the lesion(2cm),fuzzy edge,burr sign,the presence of suspicious lymph nodes,and rich blood supply suggested poor differentiation and high histological grade of the disease.There was no correlation between malignant calcification and its location(p < 0.05).ConclusionDBT+FFDM has the advantages on inspection than FFDM in the diagnostic performance,by ultrasonic can better with DBT + FFDM forecast for histologic classification of breast cancer,cancer(≥2 cm)or higher,the greater the suspicious of axillary lymph nodes,burr sign,rich blood flow signal hint the lesions,poorly differentiated histological grade is high,and malignant calcification,tumor position can not be used to histologic grading.