Application of Contrast-Enhanced Ultrasound in the Differential Diagnosis of Different Molecular Subtypes of Breast Cancer

Abstract

To explore the value of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of molecular subtypes of breast cancer. Sixty-two cases of breast cancer were divided into luminal epithelium A or B subtype (luminal A/B), Her-2 over-expression subtype and triple negative subtype (TN). CEUS and routine ultrasonography were performed for all patients before surgery. (1) The luminal epithelium subtype contrast enhancement pattern was more likely to present with radial edge (76.92%, p < 0.05) and low perfusion (69.23%, p < 0.05). The maximum intensity (IMAX) was lower in the luminal epithelium subtype (p < 0.05). (2) The Her-2 over-expression subtype contrast enhancement pattern was more likely to present with centripetal enhancement (93.75%, p < 0.05) and perfusion defect (75.0%, p < 0.05), and the time to peak (TTP) was shorter (80.0%, p < 0.05). (3) The contrast enhancement pattern of the triple negative subtype was shown to have a clear boundary. Compared to the other two subtypes, the triple negative subtype did not have significantly different perfusion parameters (p > 0.05). (4) Our study showed that the areas under the ROC curve for radial edge, low perfusion and IMAX for the luminal epithelium subtype breast lesions were 76.5%, 75.6%, and 82.1%, respectively. Additionally, the areas under the ROC curve for centripetal enhancement, perfusion defect and TTP for the Her-2 over-expression subtype breast lesions were 68.6%, 92.4%, and 97.8%, respectively. The sensitivity, specificity, and diagnostic accuracy of clear boundaries in detecting triple negative subtype breast lesions were 90.5%, 80.0%, and 91.9%, respectively.