DOI QR코드

DOI QR Code

Ultrasonographic Features of Triple-Negative Breast Cancer: a Comparison with Other Breast Cancer Subtypes

  • Yang, Qi (Cancer Center, The First Hospital of Jilin University) ;
  • Liu, Hong-Yan (Haidian Maternal & Child Health Hospital) ;
  • Liu, Dan (Changchun Mental Hospital, The First Hospital of Jilin University) ;
  • Song, Yan-Qiu (Cancer Center, The First Hospital of Jilin University)
  • Published : 2015.04.29

Abstract

Background: Triple-negative breast cancer (TNBC) is known to be associated with aggressive biologic features and a poor clinical outcome. Therefore, early detection of TNBC without missed diagnosis is a requirement to improve prognosis. Preoperative ultrasound features of TNBC may potentially assist in early diagnosis as characteristics of disease. Purpose: To retrospectively evaluate the sonographic features of TNBC compared to ER (+) cancers which include HER(-) and HER2 (+), and HER2 (+) cancers which are ER (-). Materials and Methods: From June 2012 through June 2014, sonographic features of 321 surgically confirmed ER (+) cancers (n=214), HER2 (+) cancers (n=66), and TNBC (n=41) were retrospectively reviewed by two ultrasound specialists in consensus. The preoperative ultrasound and clinicopathological features were compared between the three subtypes. In addition, all cases were analyzed using morphologic criteria of the ACR BI-RADS lexicon. Results: Ultrasonographically, TNBC presented as microlobulated nodules without microcalcification (p=0.034). A lower incidence of ductal carcinoma in situ (p<0.001), invasive tumor size that is>2 cm (p=0.011) and BI-RADS category 4 (p<0.001) were significantly associated with TNBC. With regard to morphologic features of 41 TNBC cases, ultrasonographically were most likely to be masses with irregular (70.7%) microlobulated shape (48.8%), be circumscribed (17.1%) or have indistinct margins (17.1%) and parallel orientation (68.9%). Especially TNBC microlobulated mass margins were more more frequent than with ER (+) (2.0%) and HER2 (+) (4.8%) cancers. Conclusions: TNBC have specific characteristic in sonograms. Ultrasonography may be useful to avoid missed diagnosis and false-negative cases of TNBC.

Keywords

Breast cancer;molecular subtypes;TNBC;neoplasms;ultrasonography

References

  1. Bauer KR, Brown M, Cress RD, et al (2007). Descriptive analysis of estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and HER2-negative invasive breast cancer, the so-called triple-negative phenotype: A population-based study from the california cancer registry. Cancer, 109, 1721-8. https://doi.org/10.1002/cncr.22618
  2. Bo Li, Xin Zhao, Shao-Chun Dai, et al (2014). Associations between mammography and ultrasound imaging features and molecular characteristics of triple-negative breast cancer. Asian Pac J Cancer Prev, 15, 8-3555
  3. Dent R, Trudeau M, Pritchard KI, et al(2007). Triple-negative breast cancer: Clinical features and patterns of recurrence. Clin Cancer Res, 13, 4429-34. https://doi.org/10.1158/1078-0432.CCR-06-3045
  4. Dogan BE, Gonzalez-Angulo AM, Gilcrease M, et al(2010). Multimodality imaging of triple receptornegative tumors with mammography, ultrasound, and MRI. Am J Roentgenol, 194, 1160-6. https://doi.org/10.2214/AJR.09.2355
  5. Doreen C, Donovan A (2011). Triple negative breast cancer:therapeutic and prognostic implications. Asian Pac J Cancer Prev, 12, 2129-33.
  6. Krizmanich-Conniff KM, Paramagul C, Patterson SK, et al(2012). Triple receptor-negative breast cancer: Imaging and clinical characteristics. Am J Roentgenol, 199, 458-64. https://doi.org/10.2214/AJR.10.6096
  7. Luo X, Shi YX, Li ZM, Jiang WQ (2010). Expression and clinical significance of androgen receptor in triple negative breast cancer. Chin J Cancer, 29, 585-90. https://doi.org/10.5732/cjc.009.10673
  8. Li CY, Zhang S, Zhang XB, et al (2013). Clinicopathological and prognostic characteristics of triple-negative breast cancer (TNBC) in Chinese patients: a retrospective study. Asian Pac J Cancer Prev, 14, 3779-84. https://doi.org/10.7314/APJCP.2013.14.6.3779
  9. Mi Young Kim, Nami Choi(2013). Mammographic and ultrasonographic features of triple-negative breast cancer:a comparison with other breast cancer subtypes. Acta Radiologica, 54, 889-94. https://doi.org/10.1177/0284185113488580
  10. Mousumi Sharma, Jagannath Dev Sharma, Anupam Sarma, et al (2014). Triple negative breast cancer in people of north east india: critical insights gained at a regional cancer centre. Asian Pac J Cancer Prev, 15, 11-4507. https://doi.org/10.7314/APJCP.2014.15.1.11
  11. Pal SK, Childs BH, Pegram M(2011). Triple negative breast cancer: Unmet medical needs. Breast Cancer Res Treat, 125, 627-36. https://doi.org/10.1007/s10549-010-1293-1
  12. Rakha EA, El-Sayed ME, Green AR, et al (2007). Prognostic markers in triple-negative breast cancer. Cancer, 109, 25-32. https://doi.org/10.1002/cncr.22381
  13. Sahoo PK, Jana D, Mandal PK, et al(2014). Effect of lymphangiogenesis and lymphovascular invasion on the survival pattern of breast cancer patients. Asian Pac J Cancer Prev, 15, 15-6287.
  14. Widodo I, Dwianingsih EK, Triningsih E (2014). Clinicopathological features of indonesian breast cancers with different molecular subtypes. Asian Pac J Cancer Prev, 15, 15-6109.
  15. Wojcinski S, Soliman AA, Schmidt J, et al(2012). Sonographic features of triple-negative and non-triple-negative breast cancer. J Ultrasound Med, 31, 1531-4.

Cited by

  1. Identification of Specific miRNA Signature in Paired Sera and Tissue Samples of Indian Women with Triple Negative Breast Cancer vol.11, pp.7, 2016, https://doi.org/10.1371/journal.pone.0158946
  2. HER-2 Positive Breast Cancer - a Mini-Review vol.17, pp.4, 2016, https://doi.org/10.7314/APJCP.2016.17.4.1609
  3. MicroRNAs in the development and neoplasia of the mammary gland vol.6, pp.2046-1402, 2017, https://doi.org/10.12688/f1000research.12005.2
  4. Machine learning for diagnostic ultrasound of triple-negative breast cancer pp.1573-7217, 2018, https://doi.org/10.1007/s10549-018-4984-7
  5. Radiomics of US texture features in differential diagnosis between triple-negative breast cancer and fibroadenoma vol.8, pp.1, 2018, https://doi.org/10.1038/s41598-018-31906-4
  6. Triple-negative invasive breast carcinoma: the association between the sonographic appearances with clinicopathological feature vol.8, pp.1, 2018, https://doi.org/10.1038/s41598-018-27222-6
  7. Automated Three-dimensional Breast US for Screening: Technique, Artifacts, and Lesion Characterization vol.38, pp.3, 2018, https://doi.org/10.1148/rg.2018170162
  8. miR-221 stimulates breast cancer cells and cancer-associated fibroblasts (CAFs) through selective interference with the A20/c-Rel/CTGF signaling vol.37, pp.1, 2018, https://doi.org/10.1186/s13046-018-0767-6