Thakur Shruti, Thakur Charu Smita, Thakur Vijay, Rana Nidhi, Jhobta Anupam, Kapila Sumala
Radiodiagnosis, Indira Gandhi Medical College and Hospital (IGMC), Shimla, Himachal Pradesh, India.
J Ultrason. 2025 Jan 23;25(100):20250003. doi: 10.15557/JoU.2025.0003. eCollection 2025 Jan.
The recognition of molecular subtypes of breast cancer has initiated a new regimen of targeted therapy. Early diagnosis is a key step in improving survival. Therefore, a cost-effective and widely available imaging tool is needed for the timely detection and prediction of the molecular profile of breast cancer.
To study the predictive value of ultrasonographic features in identifying the estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2 neu (HER2/neu) expression status, and molecular subtypes of breast cancer.
We conducted a study on 51 histopathologically proven invasive breast carcinoma cases over a period of one and a half years. The patients underwent ultrasonography followed by tissue biopsy. Sonographic parameters were assessed based on BI-RADS imaging features. The molecular subtypes of breast cancer were grouped into four subtypes based on the St. Gallen International Expert Consensus Panel. The predictive value of ultrasonographic features was then studied in relation to the hormone receptor status and molecular subtypes of breast cancer.
A significant association between posterior acoustic features and molecular subtypes was seen. Posterior acoustic shadowing was associated with progesterone receptor status with an odds ratio (OR) of 36.58, confidence interval (CI) of 5.527-866.1, and <0.001. The luminal type A molecular subtype was significantly higher in the posterior acoustic shadowing group (10 cases; 52.63%) with an OR of 3.85, CI of 1.12-13.98, and of 0.02. The proportion of patients with triple-negative molecular subtype (9 cases, 50%) was significantly higher in the posterior acoustic enhancement group, with an OR of 29.42, CI of 4.117-725.4, and <0.001. Tumors with circumscribed margins were also highly suggestive of the triple-negative molecular subtype [OR of 5.12, CI of 1.16-24.85, and of 0.03]. The association between the presence or absence of vascularity and its type with molecular subtypes failed to show statistical significance in our study, although vascularity was more frequently observed in triple-negative molecular subtype and luminal type B Her+ve cases.
Certain sonographic features are associated with the estrogen/progesterone receptor hormone receptor status and molecular subtypes of breast cancer. With validation of this association, ultrasound may serve as a basic imaging modality for predicting molecular subtypes of breast cancer even in remote areas, where immunohistochemistry hormone receptor and HER2 testing are not available.
乳腺癌分子亚型的识别开启了靶向治疗的新方案。早期诊断是提高生存率的关键步骤。因此，需要一种经济高效且广泛可用的成像工具来及时检测和预测乳腺癌的分子特征。
研究超声特征在识别雌激素受体、孕激素受体、人表皮生长因子受体2神经（HER2/neu）表达状态及乳腺癌分子亚型方面的预测价值。
我们在一年半的时间里对51例经组织病理学证实的浸润性乳腺癌病例进行了研究。患者先接受超声检查，然后进行组织活检。根据乳腺影像报告和数据系统（BI-RADS）成像特征评估超声参数。根据圣加仑国际专家共识小组将乳腺癌分子亚型分为四种亚型。然后研究超声特征与乳腺癌激素受体状态和分子亚型的预测价值。
观察到后方回声特征与分子亚型之间存在显著关联。后方声影与孕激素受体状态相关，优势比（OR）为36.58，置信区间（CI）为5.527 - 866.1，P<0.001。后方声影组中腔面A型分子亚型显著更高（10例；52.63%），OR为3.85，CI为1.12 - 13.98，P为0.02。后方回声增强组中三阴性分子亚型患者比例显著更高（9例，50%），OR为29.42，CI为4.117 - 725.4，P<0.001。边界清晰的肿瘤也高度提示三阴性分子亚型[OR为5.12，CI为1.李16 - 24.85，P为0.03]。尽管在三阴性分子亚型和腔面B型Her阳性病例中更频繁观察到血管，但在我们的研究中血管的有无及其类型与分子亚型之间的关联未显示出统计学意义。
某些超声特征与乳腺癌的雌激素/孕激素受体激素受体状态和分子亚型相关。通过对这种关联的验证，即使在无法进行免疫组化激素受体和HER2检测的偏远地区，超声也可作为预测乳腺癌分子亚型的基本成像方式。
