Ultrasonic manifestations and analysis of the clinical features of neuroendocrine carcinoma of the breast

WANG Hui; ZHANG Yong

Abstract：Objective To investigate the ultrasonic manifestations and clinical features of neuroendocrine carcinoma of the breast(NEBC)and to analyze the reasons for misdiagnosis in some cases.Methods Seven patients with a total of eight lesions(one patient had one lesion in each breast,both confirmed as NEBC)confirmed by pathology were selected in this work.Gray-scale ultrasound and color Doppler ultrasound examinations were used for the diagnosis.Results Among the seven patients with eight lesions,four lesions showed typical malignant tumor features,three lesions showed benign features(one of which was suspected to be malignant due to abnormal enlargement of the axillary lymph nodes),one lesion manifested as localized ductal dilatation and was diagnosed as intraductal papilloma.The diagnostic accuracy rate was 50.0%(4/8),and the missed diagnostic rate was 12.5%(1/8).Two patients presented with nipple discharge(one had no lesions detected on ultrasound,while the other had no lesions detected at the initial diagnosis but a ductal neoplasm was found on ductoscopy six months later,and a nodule was then detected by ultrasound).Ultrasonic findings were as follows:all seven lesions were hypoechoic,five had heterogeneous echogenicity,four had clear boundaries,six had irregular shapes,one had a regular shape(but the patient had abnormal en-largement of the right axillary lymph nodes),six had posterior acoustic enhancement,and only one lesion showed posterior at-tenuation.Microcalcifications were visible in two lesions.Lymph node metastasis in the ipsilateral axilla was observed in two cases.No abnormal enlargement of lymph nodes was seen in the supraclavicular or infraclavicular fossa.According to Adler's semi-quantitative blood flow classification,two lesions were grade Ⅲ,three were gradeⅠ～Ⅱ,and three were grade 0.Conclusion NEBC lesions are characterized by heterogeneous hypoechoic appearance,irregular shapes,posterior acoustic enhancement or no significant attenuation,infrequent microcalcifications.arger lesions often show abundant or relatively abundant blood flow sig-nals,while smaller lesions are less likely to show blood flow signals.Two-dimensional gray-scale and color Doppler ultrasound are helpful for the qualitative diagnosis of NEBC.