Indian Journal of Radiology and Imaging Indian Journal of Radiology and Imaging

BREAST RADIOLOGY
Year
: 2018  |  Volume : 28  |  Issue : 3  |  Page : 354--361

Predicting the molecular subtype of breast cancer based on mammography and ultrasound findings


S Rashmi1, S Kamala1, S Sudha Murthy2, Swapna Kotha1, Y Suhas Rao1, K Veeraiah Chaudhary1 
1 Department of Radiodiagnosis, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
2 Department of Pathology and Lab Diagnosis, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India

Correspondence Address:
Dr. S Rashmi
Consultant Radiologist, Department of Radiodiagnosis, Basvatarakam Indo American Cancer Hospital and Research Institute, Banjara Hills, Hyderabad - 500 034
India

Aim: To determine the correlation between mammography and ultrasound features of breast cancer with molecular subtypes and to calculate the predictive value of these features. Materials and Method: This is a prospective study of consecutive patients with breast cancer presenting between January 2016 and July 2017, who underwent mammography and/or ultrasound of breast and excision of the breast mass. Patients with contralateral breast mass, metastases, h/o prior cancer treatment, and other malignancies were excluded. On mammography, the presence or absence of microcalcification was noted. On ultrasound examination size, margins, microcalcification, posterior acoustic features, vascularity, and axillary nodes were assessed. Margins were categorized into circumscribed and non-circumscribed. Posterior acoustic features were classified into four categories: shadowing, enhancement, mixed, and no changes. Vascularity was assessed based on Adler's index into grades 0, 1, 2, and 3. Grades 0 and 1 were considered low and 2 and 3 were high. Results: Tumors with non-circumscribed margins and posterior acoustic shadowing were likely to be luminal A or B subtype of breast cancer [odds ratio (OR) 5.78; 95% confidence interval (CI) 3.68–9.80; P < 0.0001]. Tumors with non-circumscribed margins, posterior acoustic shadowing, and high vascularity were more likely to be luminal B subtype (OR 2.88; 95% CI 2–4.14; P- <0.0001). Tumors with microcalcification and posterior mixed acoustic pattern were strongly associated to be HER2-positive (OR 5.48; 95% CI 3.06–9.80; P < 0.0001). Tumors with circumscribed margins and posterior acoustic enhancement were highly suggestive of triple-negative breast cancer (OR 7.06; 95% CI 4.64–10.73; P < 0.0001). Conclusion: Microcalcification detected on mammography and certain ultrasound features such as circumscribed or non-circumscribed margins, posterior acoustic features, and vascularity are strongly correlated in predicting the molecular subtypes of breast cancer, and thus may further expand the role of conventional breast imaging.


How to cite this article:
Rashmi S, Kamala S, Murthy S S, Kotha S, Rao Y S, Chaudhary K V. Predicting the molecular subtype of breast cancer based on mammography and ultrasound findings.Indian J Radiol Imaging 2018;28:354-361


How to cite this URL:
Rashmi S, Kamala S, Murthy S S, Kotha S, Rao Y S, Chaudhary K V. Predicting the molecular subtype of breast cancer based on mammography and ultrasound findings. Indian J Radiol Imaging [serial online] 2018 [cited 2020 Apr 7 ];28:354-361
Available from: http://www.ijri.org/article.asp?issn=0971-3026;year=2018;volume=28;issue=3;spage=354;epage=361;aulast=Rashmi;type=0