Asian Oncology Research Journal

Correlation of Ultrasonography Features of Breast Masses with Hormone Receptor Status and Molecular Subtypes of Breast Cancer

S. R. Amritha *

Department of Radiodiagnosis, K. S. Hegde Medical Academy, Mangalore, India.

A. Rohini

Department of Radiodiagnosis, K. S. Hegde Medical Academy, Mangalore, India.

*Author to whom correspondence should be addressed.

---

Abstract

Objectives: The purpose of the study is to inquire the possibility of predicting tumour subtypes of breast cancer based on imaging features of breast lesions on ultrasonography.

Methodology: This cross-sectional study was conducted on 55 patients who were referred to the department of Radiodiagnosis of K.S.Hegde Medical Academy who were diagnosed or suspected to have breast cancer. USG features of breast lesions were characterised based on BIRADS lexicon. After histopathological confirmation and Immunohistochemistry (IHC) analysis, lesions were classified into molecular subtypes. Association of the USG features of lesions with molecular subtypes and hormone receptor status were assessed statistically.

Results: Majority of the tumours belonged to Luminal B (LB) subtype followed by Triple negative breast cancer (TNBC), human epidermal growth factor receptor 2/neu (Her 2 Neu) enriched and Luminal A (LA) subtypes in descending order. Majority of LA subtype showed non parallel orientation, posterior acoustic shadowing, calcifications and vascularity. Most of the Her 2 neu enriched subtype showed non-parallel orientation, lesion calcifications and none showed posterior acoustic features. Non parallel orientation and increased vascularity were also observed in TNBC lesions. Posterior acoustic enhancement was seen in only TNBC subtype lesion. Lesions showing posterior acoustic shadowing were associated more with Hormone receptor (HR) positive status.

Conclusion:  Though most of the subtypes of malignant breast tumours showed similar features on USG , the combination of features would help in predicting the molecular subtype to some extent.

Keywords: Ultrasonography, molecular subtypes, breast cancer, hormone receptor

---

---

---

References

Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. International Journal of Cancer. 2015;136(5):E359–86.

Sun YS, Zhao Z, Yang ZN, Xu F, Lu HJ, Zhu ZY et al. Risk Factors and Preventions of Breast Cancer. International Journal of Biological Sciences. 2017;13(11):1387.

Rashmi S, Kamala S, Murthy SS, Kotha S, Rao YS, Chaudhary KV. Predicting the molecular subtype of breast cancer based on mammography and ultrasound findings. Indian J Radiol Imaging. 2018;28(3): 354–61.

Elsaeid YM, Elmetwally D, Eteba SM. Association between ultrasound findings, tumor type, grade, and biological markers in patients with breast cancer. Egyptian Journal of Radiology and Nuclear Medicine. 2019;50(1):53.

Stavros AT, Thickman D, Rapp CL, Dennis MA, Parker SH, Sisney GA. Solid breast nodules: use of sonography to distinguish between benign and malignant lesions. Radiology. 1995;196(1):123–34.

Choi EJ, Choi H, Park EH, Song JS, Youk JH. Evaluation of an automated breast volume scanner according to the fifth edition of BI-RADS for breast ultrasound compared with hand-held ultrasound. European Journal of Radiology. 2018;99: 138–45.

Okello J, Kisembo H, Bugeza S, Galukande M. Breast cancer detection using sonography in women with mammographically dense breasts. BMC Medical Imaging. 2014;14(1):41.

Barman G, Bujarbaruah K, Choudhury BK, Kataki AC. Ultrasound evaluation of biopsy proven malignant breast mass. International Journal of Research in Medical Sciences. 2020;8(2):706–13.

Gupta K, Chandra T, Kumaresan M, Venkatesan B, Patil AB. Role of Colour doppler for assessment of malignancy in solid breast masses: A prospective study. 2017;6:7.

Davoudi Y, Borhani B, Rad MP, Matin N. The Role of doppler sonography in distinguishing malignant from benign breast lesions. Journal of Medical Ultrasound. 2014;22(2):92–5.

Vijayaraghavan GR, Kona M, Maheswaran A, Kandil DH, Toke MK, Vedantham S. Ultrasound imaging morphology is associated with biological behavior in invasive ductal carcinoma of the breast. J Clin Imaging Sci. 2021;11:48.

Algazzar MAA, Elsayed EEM, Alhanafy AM, Mousa WA. Breast cancer imaging features as a predictor of the hormonal receptor status, HER2neu expression and molecular subtype. Egypt J Radiol Nucl Med. 2020;51(1):93.

Tandon A, Srivastava P, Manchanda S, Wadhwa N, Gupta N, Kaur N et al. Role of sonography in predicting the hormone receptor status of breast cancer: A prospective study. Journal of Diagnostic Medical Sonography. 2018;34(1):3–14.

Irshad A, Leddy R, Pisano E, Baker N, Lewis M, Ackerman S et al. Assessing the role of ultrasound in predicting the biological behavior of breast cancer. American Journal of Roentgenology. 2013; 200(2):284–90.