Abstract
The aim of our study was to find effective features of mammography and ultrasound in differentiating Basal-like breast cancer (BBC) and Normal-like breast cancer (NBC), two subtypes of triple negative breast cancer (TNBC). From January 2014 to March 2017, we retrospectively reviewed 91 patients who were pathologically confirmed as TNBC. According to immunohistochemical cytokeratin 5/6 (CK5/6) and Epidermal Growth Factor Receptor (EGFR), TNBCs were classified into BBCs group and NBCs group. Both CK5/6 and EGFR were negative defined to be NBC, whereas if any of CK5/6 or EGFR was positive then defined as BBC. BBCs group concluded 65 (71.4%) cases and NBCs group concluded26 (28.6%) cases. Ultrasound images and mammograms were reevaluated by breast imaging experts according to the breast imaging reporting and data system (BI-RADS) 4th edition. On mammography, masses margins had significant differences between BBCs group and NBCs group (P = 0.024). Most BBCs margins exhibited microlobulated (30/64, 46.9%) or spiculated (25/64, 39.0%), whereas most NBCs margins exhibited microlobulated (17/23, 73.9%). On ultrasound, BBCs were more frequently to present as larger than 20mm lesions (52/65, 80.0%) and more likely to have angular or spiculated margins (35/65, 53.8%), additionally, compared with NBCs, BBCs were less likely to have calcification (1/65, 1.5%). Other mammography and ultrasound features showed no significant differences between the two groups. In conclusion, we have found some effective features of mammography and ultrasound that could be helpful in differentiating BBC and NBC, which will provide some useful references for clinical diagnosis and treatment.
Highlights
Triple-negative breast cancer (TNBC) is defined as a distinct subtype of breast cancer which lacks expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2)
We have found some effective features of mammography and ultrasound that could be helpful in differentiating Basal-like breast cancer (BBC) and Normal-like breast cancer (NBC), which will provide some useful references for clinical diagnosis and treatment
According to the gold standard microarray expression profiling analysis, triple negative breast cancer (TNBC) can be divided into two subtypes, the one is basal-like breast cancer (BBC) and the other is normal-like breast cancer (NBC) [3]
Summary
Triple-negative breast cancer (TNBC) is defined as a distinct subtype of breast cancer which lacks expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). Though adding chemotherapy or radiotherapy after surgery, recurrences or metastases always occur [2]. According to the gold standard microarray expression profiling analysis, TNBC can be divided into two subtypes, the one is basal-like breast cancer (BBC) and the other is normal-like breast cancer (NBC) [3]. Neoplastic cells express genes consistently in BBCs, such as immunohistochemical cytokeratin 5/6 (CK5/6) and epidermal growth factor receptor (EGFR) [6,7,8,9]. NBC has a slightly better prognosis and not respond to neoadjuvant chemotherapy like BBC do [17,18,19,20,21]. Early detection and classify subtypes are of great significance in clinical
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