Breast cancer imaging features as a predictor of the hormonal receptor status, HER2neu expression and molecular subtype

Maged Abdelfattah Ali Algazzar,Alshimaa Mahmoud Alhanafy,Elsayed El-Mekkawy Elsayed,Waleed Abdelfattah Mousa

doi:10.1186/s43055-020-00210-5

Maged Abdelfattah Ali Algazzar, Alshimaa Mahmoud Alhanafy + Show 2 more

Open Access

https://doi.org/10.1186/s43055-020-00210-5

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Abstract

BackgroundDetermination of the hormonal receptor (HR) status, HER2neu expression, and the molecular subtype has valuable diagnostic, therapeutic, and prognostic implications for breast cancer as breast cancer stratification during the last two decades has become dependent upon the underlying biology. The aim of this study is to assess the correlation between imaging features of breast cancer and the HR status, HER2neu expression, and the molecular subtype. Sixty breast cancer patients underwent breast ultrasound, mammography, and MRI evaluation. Pathological evaluation using immunohistochemistry and FISH was used to detect the HR status, HER2/neu expression, and the molecular subtype. Those findings were then correlated with the radiologic data.ResultsHR-positive tumors were associated with posterior acoustic shadowing (34/44, 77.3%; p = 0.004). Hormonal-negative tumors presenting as masses were more likely circumscribed on US and MRI compared to hormonal positive mass tumors (6/14, 42.9% vs 3/36, 7.7%; p = 0.003 on US and 6/13, 46.3% vs 3/36, 8.3%; P = 0.007 on MRI) and had malignant DCE kinetics with washout curves compared to the hormonal positive group (10/16, 62.5% vs 4/44, 9.1%; P < 0.001). HER2neu-positive tumors were significantly associated with calcifications and multifocality on mammography compared to HER2neu-negative group (9/13, 69% vs 12/34, 25.5%; P = 0.007) and (7/13, 53% vs 3/47, 6%; P < 0.001). TNBC and HER2neu-enriched were associated with washout kinetic curve pattern (57.1% and 66.7%, respectively). TNBCs were associated with circumscribed margins on US and MRI (6/9, 66.7%; P < 0.001).ConclusionMicrocalcifications, margins, posterior acoustic features, and malignant washout kinetics strongly correlate with the hormonal receptor status, HER2neu status, and molecular subtype of breast cancer. These findings may suggest the molecular subtype of breast cancer and further expand the role of imaging.

Highlights

Determination of the hormonal receptor (HR) status, HER2neu expression, and the molecular subtype has valuable diagnostic, therapeutic, and prognostic implications for breast cancer as breast cancer stratification during the last two decades has become dependent upon the underlying biology
Imaging features as regard hormonal receptor status (Fig. 1) On mammographic examination, HR-negative breast cancers were associated with circumscribed margins compared to HR-positive (35.7% vs 8.1%)
We found that hormonal-negative tumors were statistically different from hormonal-positive tumors as regards the mass margins, with the hormonal-negative tumors being more circumscribed on mammography, ultrasound, and Magnetic resonance imaging (MRI) with a P of 0.03, 0.03, and 0.007 respectively

Summary

Introduction

Determination of the hormonal receptor (HR) status, HER2neu expression, and the molecular subtype has valuable diagnostic, therapeutic, and prognostic implications for breast cancer as breast cancer stratification during the last two decades has become dependent upon the underlying biology. The aim of this study is to assess the correlation between imaging features of breast cancer and the HR status, HER2neu expression, and the molecular subtype. Pathological evaluation using immunohistochemistry and FISH was used to detect the HR status, HER2/neu expression, and the molecular subtype. Those findings were correlated with the radiologic data. The traditional classification of breast cancer depends on the clinicopathologic analysis of tumors, defining breast cancer by histopathologic features. Gallen International Expert Consensus Panel [5]

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