Is There a Correlation between Multiparametric Assessment in Ultrasound and Intrinsic Subtype of Breast Cancer?

Magdalena Gumowska,Katarzyna Dobruch-Sobczak,Piotr Prostko,Joanna Mączewska,Katarzyna Roszkowska-Purska

doi:10.3390/jcm10225394

Abstract

Molecular profile of breast cancer provides information about its biological activity, prognosis and treatment strategies. The purpose of our study was to investigate the correlation between ultrasound features and molecular subtypes of breast cancer. From June 2019 to December 2019, 86 patients (median age 57 years; range 32–88) with 102 breast cancer tumors were included in the study. The molecular subtypes were classified into five types: luminal A (LA), luminal B without HER2 overexpression (LB HER2−), luminal B with HER2 overexpression (LB HER2+), human epidermal growth factor receptor 2 positive (HER2+) and triple negative breast cancer (TNBC). Histopathological verification was obtained in core biopsy or/and post-surgery specimens in all cases. Univariate logistic regression analysis was performed to assess the association between the subtypes and ultrasound imaging features. Experienced radiologists assessed lesions according to the BIRADS-US lexicon. The ultrasound scans were performed with a Supersonic Aixplorer and Supersonix. Based on histopathological verification, the rates of LA, LB HER2−, LB HER2+, HER2+, and TNBC were 33, 17, 17, 16, 19, respectively. Both LB HER2+ and HER2+ subtypes presented higher incidence of calcification (OR = 3.125, p = 0.02, CI 0.0917–5.87) and HER2+ subtype presented a higher incidence of posterior enhancement (OR = 5.75, p = 0.03, CI 1.2257–32.8005), compared to other subtypes. The calcifications were less common in TNBC (OR = 0.176, p = 0.0041, CI 0.0469–0.5335) compared to other subtypes. There were no differences with regard to margin, shape, orientation, elasticity values and vascularity among five molecular subtypes. Our results suggest that there is a correlation between ultrasonographic features assessed according to BIRADS-US lexicon and BC subtypes with HER2 overexpression (both LB HER2+ and HER2+). It may be useful for identification of these aggressive subtypes of breast cancer.

Highlights

Breast cancer (BC) is characterized by marked heterogeneity, regarding clinical and radiographic presentation, as well as response to therapy. It is largely caused by polymorphism of histological types and variable molecular profile of specific BC types
We found statistically significant association between the tumor size and the two groups of BC subtypes, i.e., aggressive and luminal (p = 0.0252, odds and ratio (OR) 1.045, confidence interval (CI) 1.0078–1.0896)
Results of our study indicate that presence of certain features can suggest triple negative breast cancer (TNBC) and

Summary

Introduction

Breast cancer (BC) is characterized by marked heterogeneity, regarding clinical and radiographic presentation, as well as response to therapy. It is largely caused by polymorphism of histological types and variable molecular profile of specific BC types. Introduction of immunohistochemistry testing (IHC) to routine practice resulted in a significant progress in understanding BC biology. IHC testing is the basis for classification of four main BC subtypes: luminal A (LA), luminal B (LB), human epidermal growth factor receptor 2 positive (HER2+) and triple negative (TNBC, so called basal breast cancer). LB was further subdivided into two subtypes: LB HER2− and LB with HER2 overexpression (LB HER2+)

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