Ultrasound Signs Of Different Molecular Subtypes Of Invasive Ductal Carcinoma Of Breast

Objective:To retrospectively analyze the relationship between ultrasound features and molecular typing of breast invasive ductal carcinoma lesions,to provide an important basis for evaluating different molecular typing of breast cancer,and to make clinical diagnosis,treatment and prognosis of breast cancer faster,more convenient and effective.Methods:The complete data of 100 female invasive ductal carcinomas of the breast who were first seen in our department of nail and breast surgery from November 2018 to December 2019 were collected,including their surgical data and pathological results of breast mass resection or puncture.Before surgery,routine ultrasound examinations and elastography strain rate ratios and shear wave velocity measurements were performed.Immunohistochemical tests were performed on the included subjects.Based on the results of ER,PR,HER-2,and Ki67 in the immunohistochemical test results.The expression was divided into 4 groups:Luminal A,Luminal B,HER-2 overexpression,Basal-like(basal-like),and the four molecular subtypes were further grouped into Luminal.The statistical software SPSS20.0 was used in the two groups of non-Luminal and non-Luminal type to analyze and compare the relationship between breast cancer of different molecular subtypes and conventional ultrasound performance,and calculate the elastography technology(strain rate ratio method,acoustic palpation tissue quantitative technology)Specificity and sensitivity for the diagnosis of Luminal and non-Luminal lesions.ROC curve analysis was used to compare the diagnostic efficacy of the two elastography techniques.Results:1.There were no significant differences in blood flow abundance and lymph node metastasis between lesions with different molecular types(P>0.05).2.The overall difference in pathological grade between the four different molecular subtypes of breast cancer was statistically significant(P<0.05).3.Ultrasound manifestations of the largest diameter,orientation,morphology,margin,calcification,and posterior features of the masses were statistically significant in the examination of different molecular subtype lesions(P<0.05).Compared with other subtypes,calcification is most likely to occur in HER-2 overexpression;basal-like patterns have a higher incidence of posterior echo,regular morphology,and higher edge smoothing;LuminalB type tumors often grow vertically with burrs,Luminal A type lesions with a maximum diameter of<2 cm are more likely to appear.4.Acoustic palpation tissue quantification technology for the diagnosis of Luminal type and non-Luminal type shows that the area under the ROC curve is 0.774,the best cutoff value is 5.95m/s,the sensitivity is 92.6%,and the specificity is 68.5%.5.The strain rate ratio method for Luminal and non-Luminal diagnosis showed that the area under the ROC curve was 0.756,the best cutoff was 5.15,the sensitivity was 81.5%,and the specificity was 65.8%.Conclusions:1.The different molecular types of invasive ductal carcinoma are related to the histological grade of the lesion.2.Different molecular subtypes of lesions have different ultrasound signs.There is a certain correlation between the two.3.The elastography strain rate ratio(SR)method and acoustic palpation tissue quantification(VTQ)technology are of certain value for the diagnosis of Luminal and non-Luminal types of breast cancer.