Association between multimodal ultrasound characteristics and molecular subtypes of T1 breast cancer

LIAO Chunxu; ZHANG Huijuan; ZHANG Lijuan; WU Guanghua; LIN Zhigao

Abstract：Objective To investigate the correlation between multimodality ultrasound features(conventional ultrasound,strain elasticity,contrast-enhanced ultrasound)and molecular subtypes of T1 breast cancer.Methods A total of 697 consecu-tive breast patients in our hospital were selected,and 99 patients(99 lesions)were included after inclusion and exclusion crite-ria.All patients received conventional ultrasound,elastic ultrasound and CEUS examination before surgery.Breast cancer mo-lecular subtypes were identified by postoperative pathological and immune-histochemical analysis as Luminal A,Luminal B,HER-2 overexpression,and basal-like.The nonparametric Kruskal-Wallis test,Pearson's χ2 test,or Fisher's exact probability method were used to compare and analyze the multimode ultrasonic characteristics of different molecular subtypes,and the pair-to-pair comparison was corrected by Bonferroni method.Results Among the 4 subtypes,there were significant differences in the direction(parallel or non-parallel),edge(blurred or clear),strain elasticity score,enhancement speed(synchronous or rapid enhancement),contrast agent perfusion direction(global,concentric,or eccentric)and whether the lesion size increased after enhancement;Pairwise comparison of significant indicators showed that the enhancement speed,contrast agent perfusion di-rection and lesion range after enhancement had statistical significance in CEUS(P<0.05).Luminal B had a faster enhancement rate than luminal A.Compared with Luminal B,HER-2 overexpression showed more centripetal enhancement,Luminal A and Luminal B showed more centrifugal enhancement.Compared with HER-2 overexpression type,Luminal A had a higher propor-tion of range enlargement.Conclusion In different molecular subtypes of T1 breast cancer,the characteristics of conventional ultrasound and strain elastography are different,but their value is limited,while the contrast ultrasound mode is significantly dif-ferent.The characteristics of contrast ultrasound may be an important parameter for predicting different molecular subtypes of breast cancer.