CORRELATION BETWEEN ULTRASOUND FINDINGS AND MOLECULAR SUBTYPES OF BREAST CANCER

Background: Breast cancer is the most common malignant tumor and the major cause of death among women worldwide. Molecular subtyping of breast cancer is important to individualize its management, to understand prognosis of disease and avoid overtreatmen.
Aim of Study: The current study aimed at correlating the breast cancer subtypes with their different ultrasound criteria. The ultrasound findings might have an important role in predicting different groups.
Patients and Methods: The current study is a retrospective study. Which was conducted on 40 females patients with breast cancer; during the period from November 2020 till March 2021.The age were 45-65 years old. They were presented to the Radiology Department, Ain-Shams University, Faculty of Medicine. The selected cases had been afforded from: the Breast-unit of General Surgery Hospital, El Demerdash University Hospital,, Clinical Oncology & Nuclear Medicine Department.
Results: When analyzing the main four breast cancer subtypes in the current work we found that the rates of Luminal A was 34%, Luminal B was 40%, HER2 was 15%, and TNBC was 11%. LA subtype was strongly associated with hypoechoic lesions showing irregular shape, speculated margin surrounded by desmoplastic reaction with posterior shadowing. LB subtype was associated with irregular shape and speculated margin with absence of desmoplastic reaction.
Human Epidermal Growth Factor (HER2) subtype in the current study was found to be associated with irregular shape, lobulated margin, absent desmoplastic reaction with posterior acoustic mixed shadowing and enhancement. This could be related to suspicious microcalcifications. Triple Negative Breast Cancer (TNBC) lesions in the present work were predominantly oval in shape with circumscribed margin; the benign looking malignant lesions which carry the worst prognosis. Based on the latter finding, the good radiologist should be aware about ultround features of different molecular subtype in order not to under diagnose a malignant breast lesion.
Conclusion: The sonographic features as margin, shape, posterior acoustic features were significantly associated with molecular subtypes. The histopathological grade and hormone receptor status. Being able to predict the molecular subtype. The current study recommend that the radiologist should be aware about different imaging features of different molecular subtypes especially the triple negative breast cancer which had the most benign looking criteria aiming for better lesion characterization and to allow the patient to benefit from earlier non-invasive, cheap diagnosis and the curable on time treatment.