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BREAST IMAGING Table of Contents   
Year : 2018  |  Volume : 28  |  Issue : 1  |  Page : 123-131
Sonographic features of invasive ductal breast carcinomas predictive of malignancy grade


1 Department of Radiodiagnosis, ESI Medical College and PGIMSR, Chennai, Tamil Nadu, India
2 Department of Pathology, ESI Medical College and PGIMSR, Chennai, Tamil Nadu, India
3 Department of Radiology, University of Central Florida, Orlando, USA
4 Department of Community Medicine, ESI Medical College and PGIMSR, Chennai, Tamil Nadu, India
5 Department of Obstetrics and Gynecology, ESI Medical College and PGIMSR, Chennai, Tamil Nadu, India

Correspondence Address:
Dr. Kanika Gupta
Department of Radiodiagnosis, ESI Medical College and PGIMSR, K K Nagar, Chennai - 600 078, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijri.IJRI_257_17

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Context: Assessment of individual sonographic features provides vital clues about the biological behavior of breast masses and can assist in determining histological grade of malignancy and thereby prognosis. Aims: Assessment of individual sonographic features of biopsy proven invasive ductal breast carcinomas as predictors of malignancy grade. Settings and Design: A retrospective analysis of sonographic findings of 103 biopsy proven invasive ductal breast carcinomas. Materials and Methods: Tumor characteristics on gray-scale ultrasound and color flow were assessed using American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) Atlas Fifth Edition. The sonographic findings of masses were individually correlated with their histopathologic grades. Statistical Analysis Used: Chi square test, ordinal regression, and Goodman and Kruskal tau test. Results: Breast mass showing reversal/lack of diastolic flow has a high probability of belonging to histological high grade tumor ( β 1.566, P 0.0001). The masses with abrupt interface boundary are more likely grade 3 ( β 1.524, P 0.001) in comparison to masses with echogenic halos. The suspicious calcifications present in and outside the mass is a finding associated with histologically high grade tumors. The invasive ductal carcinomas (IDCs) with complex solid and cystic echotexture are more likely to be of high histological grade ( β 1.146, P 0.04) as compared to masses with hypoechoic echotexture. Conclusions: Certain ultrasound features are associated with tumor grade on histopathology. If the radiologist is cognizant of these sonographic features, ultrasound can be a potent modality for predicting histopathological grade of IDCs of the breast, especially in settings where advanced tests such as receptor and molecular analyses are limited.


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