Associations Between Mammography and Ultrasound Imaging Features and Molecular Characteristics of Triple-negative Breast Cancer

Background: The triple-negative breast cancer (TNBC) is an aggressive cancer characterized by the absenceof estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2).Preoperative mammography and ultrasound features of TNBC may potentially suggest characteristics of thedisease and assist in treatment decisions. Materials and
Methods: The study covered 153 patients with TNBCfrom May 2011 to May 2012 who were confirmed by postoperative pathology results in our hospital. We comparedthe radiological findings among the patients and sought to determine the significant iconographic features. Thebiomarkers p53 and Ki-67 are regarded as significant factors in TNBC. They were therefore used to divide theTNBC into four groups for assessment of relationships with TNBC imaging features.
Results: On mammography,most TNBCs exhibit obscure (44.3%) masses. On ultrasound, the majority of masses (95.4%) were predominantlyindistinct (50.7%), irregular (76.0%) or featuring posterior echo enhancement/shadowing. Color Doppler flowimaging (CDFI) emphasized hypervascular (32.9%) masses. Differences in CDFI by ultrasound among the fourgroups were statistically significant (p=0.009). There were obvious differences in the percentages of spiculatedmargin (p=0.049) and intensive posterior echo (p=0.006) with spotty flow imaging by ultrasound between theKi-67 (+) p53 (+) and other groups.
Conclusions: A combination of mammography and ultrasound revealedthe imaging characteristics of TNBC included an obscure mass with less attenuated posterior echoes and somevascularity. A worse prognosis was associated with spiculated margin and intensive posterior echoes with spottyflow imaging.