Study On The Imaging Characteristics Of Molecular Subtypes Of Breast Invasive Ductal Carcinoma Based On DBT And 3.0T MRI

Objective To explore the imaging features of different molecular subtypes of invasive ductal carcinoma of the breast on digital breast tomography(DBT)and 3.0T MRI,so as to provide more reference basis for the selection of clinical treatment and prediction of prognosis.Methods A retrospective analysis was performed on 106 patients with invasive ductal carcinoma of the breast diagnosed by surgery and pathology in our hospital from January 2018 to September 2019.The patients had complete DBT and 3.0T MRI images before operation.According to the immunohistochemical staining of pathology,breast cancer was divided into Luminal A type,Luminal B type,HER-2+type and triple negative type(TNBC).To analyze the features of DBT,MRI and clinicopathology of invasive ductal carcinoma with different molecular subtypes.Results Among 106 cases of invasive ductal carcinoma of the breast,there were 22cases of Luminal A,57 cases of Luminal B,14 cases of HER-2+and 13 cases of TNBC.In the clinicopathological features,there was no significant difference in age,menopause,location and axillary lymph node metastasis among different molecular subtypes of invasive ductal carcinoma(P>0.05).In pathological classification,Luminal A,Luminal B and TNBC were more common in grade?,accounting for68.18%,70.18%,and 53.85%,respectively,and HER-2+was more common in grade?,accounting for 64.29%,and the difference was statistically significant(?~2=25.366,P<0.001).In the DBT manifestations,there was no significant difference in breast gland density,tumor shape,density,malignant calcification type and distribution among different molecular subtypes of invasive ductal carcinoma(P>0.05).Among the features of tumor margins,Luminal A,Luminal B and HER-2+tumor margins were more burr,accounting for 75.00%,50.94%,and 38.46%,respectively,and the edge of the TNBC mass was more common with lobes,accounting for 54.55%,the difference was statistically significant(?~2=18.721,P=0.011);Luminal B and HER-2+invasive ductal carcinoma with malignant calcification accounted for a higher proportion(61.40%,57.14%respectively),the difference was statistically significant(?~2=13.952,P=0.003).On MRI,there was no difference in lesion size between different molecular subtypes(P>0.05).Among the enhancement types,Luminal A,Luminal B were mainly heterogeneous enhancement,accounting for 63.64%and 75.44%,respectively.and TNBC was mainly annular reinforcement,accounting for 61.54%,and the difference was statistically significant(?~2=13.230,P=0.020).Among the TIC curve types,Luminal A,Luminal B,HER-2+and TNBC were more common in type III,accounting for 54.55%,71.93%,100.00%,and 53.85%,respectively,The difference was statistically significant(?~2=10.180,P=0.017);The mean ADC values of Luminal A,Luminal B,HER-2+and TNBC invasive ductal carcinoma were(0.87±0.16)×10~-33 mm~2/s,(0.83±0.14)×10~-33 mm~2/s,(0.95±0.16)×10~-33 mm~2/s and(1.00±0.20)×10~-33 mm~2/s,respectively,with statistically significant differences(F=5.222,P=0.002).The mean ADC value of the TNBC was higher than that of Luminal A and Luminal B(P<0.05),and the mean ADC value of the HER-2+was higher than that of Luminal B(P<0.05).Conclusion There were some differences in the DBT and MRI images of invasive ductal carcinoma of the breast with different molecular subtypes.The evaluation of preoperative molecular subtypes by DBT and MRI can provide more references for the selection of clinical treatment programs and the prediction of prognosis.