Department for Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany.
BMC Womens Health. 2013 Nov 19;13:47. doi: 10.1186/1472-6874-13-47.
The aim of this study was to evaluate the relation of some ultrasound morphological parameters to biological characteristics in breast carcinoma.
Ultrasound data from 315 breast masses were collected. We analyzed the ultrasound features of the tumors according to the ACR BI-RADS®-US classification system stratified by hormone receptor status, HER2 status, histology grade, tumor type (ductal versus lobular), triple-negativity, breast density, tumor size, lymph node involvement and patient's age.
We found a variety of ultrasound features that varied between the groups. Invasive lobular tumors were more likely to have an angulated margin (39% versus 22%, p = 0.040) and less likely to show posterior acoustic enhancement (3% versus 16%, p = 0.023) compared to invasive ductal carcinoma. G3 tumors were linked to a higher chance of posterior acoustic enhancement and less shadowing and the margin of G3 tumors was more often described as lobulated or microlobulated compared to G1/G2 tumors (67% versus 46%, p = 0.001). Tumors with an over-expression of HER2 exhibited a higher rate of architectural distortions in the surrounding tissue, but there were no differences regarding the other features. Hormone receptor negative tumors were more likely to exhibit a lobulated or microlobulated margin (67% versus 50%, p = 0.037) and less likely to have an echogenic halo (39% versus 64%, p = 0.001). Furthermore, the posterior acoustic feature was more often described as enhancement (33% versus 13%, p = 0.001) and less often as shadowing (20% versus 47%, p < 0.001) compared to hormone receptor positive tumors.
Depending on their biological and clinical profile, breast cancers are more or less likely to exhibit the typical criteria for malignancy in ultrasound. Moreover, certain types of breast cancer tend to possess criteria that are usually associated with benign masses. False-negative diagnosis may result in serious consequences for the patient. For the sonographer it is essential to be well aware of potential variations in the ultrasound morphology of breast tumors, as described in this paper.
本研究旨在评估一些超声形态参数与乳腺癌生物学特征的关系。
收集了 315 个乳腺肿块的超声数据。我们根据激素受体状态、HER2 状态、组织学分级、肿瘤类型（导管性与小叶性）、三阴性、乳腺密度、肿瘤大小、淋巴结受累和患者年龄，按照 ACR BI-RADS®-US 分类系统对肿瘤的超声特征进行分析。
我们发现了各种在组间存在差异的超声特征。与浸润性导管癌相比，浸润性小叶癌更有可能具有倾斜的边缘（39%对 22%，p=0.040）和较少出现后方声增强（3%对 16%，p=0.023）。G3 肿瘤与更高的后方声增强和更少的声影相关，与 G1/G2 肿瘤相比，G3 肿瘤的边缘更常被描述为分叶状或微分叶状（67%对 46%，p=0.001）。HER2 过表达的肿瘤周围组织中出现结构扭曲的比例更高，但其他特征无差异。激素受体阴性肿瘤更有可能出现分叶状或微分叶状边缘（67%对 50%，p=0.037）和较少出现回声晕（39%对 64%，p=0.001）。此外，与激素受体阳性肿瘤相比，后方声特征更常被描述为增强（33%对 13%，p=0.001），而较少被描述为声影（20%对 47%，p<0.001）。
根据其生物学和临床特征，乳腺癌在超声中更有可能或不太可能表现出典型的恶性肿瘤标准。此外，某些类型的乳腺癌往往具有通常与良性肿块相关的标准。错误的阴性诊断可能会对患者造成严重后果。对于超声医师来说，了解本文所述的乳腺肿瘤超声形态的潜在变化至关重要。
