Association Between Contrast‐Enhanced Ultrasound Characteristics and Molecular Subtypes of Breast Cancer

Wen, Baojie; Kong, Wencheng; Zhang, Yidan; Haiyan, Xue; Wu, Min; Wang, Rui

doi:10.1002/jum.15886

Cited by 11 publications

(8 citation statements)

References 45 publications

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“…TNBC tumours in our study had a propensity to show oval shape with microlobulated and circumscribed margins. This finding is in agreement with previously conducted studies which also demonstrated oval shape with circumscribed margins as a feature of TNBC rather than the luminal epithelium subtype, which are often seen as irregular mass with angular and spiculated margins consequent to slow infiltration [ 12 , 13 , 21 , 22 ]. The smooth appearance has also been linked with the rapidity of tumour progression [ 15 , 23 ].…”

Section: Discussionsupporting

confidence: 93%

“…The prognosis of the TN subtype remains the worst and chemotherapy forms the mainstay of treatment for this subtype [ 19 ]. This heterogeneous behaviour of breast cancer has prompted studies regarding the parameters which may potentially allow differentiation of the various subtypes from each other in recent years [ 13 , 15 , 16 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

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Imaging features of breast cancer subtypes on contrast enhanced ultrasound: a feasibility study

Chandola,

Dhamija,

Paul

et al. 2023

ecancer

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The objective of this research was to study the contrast enhancement patterns of the different molecular subtypes of breast cancer on contrast-enhanced ultrasound (CEUS) using both qualitative and quantitative parameters. This prospective study included females with a single breast mass which was histopathologically proven carcinoma. B mode ultrasound (USG) and CEUS were performed in all patients during baseline assessment. Qualitative CEUS assessment encompassed enhancement pattern, presence of fill-in and washout. Quantitative assessment included measurement of peak enhancement, time to peak; area under the curve and mean transit time. A p -value < 0.05 was considered statistically significant for differentiating the subtypes. The included thirty masses were categorised into two subtypes—triple negative breast cancer (TNBC) (36.7%) and non-TNBC (63.3%) subtypes. With B-mode USG, a statistically significant difference was observed between the two groups with respect to their shape and margins. TNBC lesions showed an oval shape, circumscribed margins and peripheral nodular enhancement on CEUS with the absence of fill-in even in the delayed phase ( p -value – 0.04). The two subtypes did not significantly differ in terms of quantitative perfusion parameters. The various subtypes of breast cancer therefore possess distinct contrast enhancement patterns. CEUS potentially allows differentiation amongst these molecular subtypes that may aid in radiology-pathology (rad-path) correlation and follow up of the patients.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Imaging features of breast cancer subtypes on contrast enhanced ultrasound: a feasibility study

Chandola,

Dhamija,

Paul

et al. 2023

ecancer

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“…Our results concur with those of Wen B et al. ( 24 ) in that HER-2 overexpressed and triple-negative breast lesions can secrete more vascular endothelial growth factor, leading to higher angiogenesis and vascular permeability and significant hyper-perfusion situation in the tumors.…”

Section: Discussionsupporting

confidence: 93%

Contrast-enhanced ultrasound for the preoperative prediction of pathological characteristics in breast cancer

Li,

Su,

Deng

et al. 2024

Front. Oncol.

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ObjectiveWe aimed to investigate the value of contrast-enhanced ultrasound (CEUS) in the preoperative prediction of the histological grades and molecular subtypes of breast cancer.MethodsA total of 183 patients with pathologically confirmed breast cancer were included. Contrast enhancement patterns and quantitative parameters were compared in different groups. The receiver operating characteristic (ROC) curve was used to analyze the efficacy of CEUS in the preoperative prediction of pathological characteristics, including histologic grade and molecular subtypes.ResultsHeterogeneous enhancement, perfusion defects, and peripheral radial vessels were mostly observed in higher histologic grade (grade III) breast cancer. Heterogeneous enhancement and perfusion defect were the most effective indicators for grade III breast cancer, with the areas under the ROC curve of 0.768 and 0.756, respectively. There were significant differences in the enhancement intensity, post-enhanced margin, perfusion defects, and peripheral radial vessel among the different molecular subtypes of breast cancer (all P < 0.01). Perfusion defects and clear edge after enhancement were the best qualitative criteria for the diagnosis of HER-2 overexpressed and triple-negative breast cancers, and the corresponding areas under the ROC curves were 0.804 and 0.905, respectively. There were significant differences in PE, WiR, WiPI, and WiWoAUC between grade III vs grade I and II breast cancer (P < 0.05). PE, WiR, WiPI, and WiWoAUC had good efficiency in the diagnosis of high-histologic-grade breast cancer. PE had the highest diagnostic efficiency in Luminal A, while WiPI had the highest diagnostic efficiency in Luminal B subtype breast cancer, and the areas under the ROC curve were 0.825 and 0.838, respectively. WiWoAUC and WiR were the most accurate parameters for assessing triple-negative subtype breast cancers, and the areas under the curve were 0.932 and 0.922, respectively.ConclusionQualitative and quantitative perfusion analysis of contrast-enhanced ultrasound may be useful in the non-invasive prediction of the histological grade and molecular subtypes of breast cancers.

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“…The qualitative CEUS features were evaluated according to the literatures, 15–17 including: (1) shape after enhancement (regular, irregular); (2) margin after enhancement (clear, unclear); (3) enhanced homogeneity (homogeneous, heterogeneous); (4) perfusion defect (absent, present); (5) enhanced direction (diffuse, centripetal, centrifugal); and (6) nourishing vessels (absent, present).…”

Section: Methodsmentioning

confidence: 99%

“…Tumor shape, margin, echo pattern, orientation, posterior features, echogenic rim, and micro-calcification were assessed according to the ACR BI-RADS Atlas 5th edition ultrasound lexicon. 14 The qualitative CEUS features were evaluated according to the literatures, [15][16][17] including: (1) shape after enhancement (regular, irregular); (2) margin after enhancement (clear, unclear); (3) enhanced homogeneity (homogeneous, heterogeneous); (4) perfusion defect (absent, present); (5) enhanced direction (diffuse, centripetal, centrifugal); and (6) nourishing vessels (absent, present).…”

Section: Gray Scale Ultrasound and Ceus Analysismentioning

confidence: 99%

Evaluating Tumor‐Infiltrating Lymphocytes in Breast Cancer

Jia

Zhu

et al. 2022

J of Ultrasound Medicine

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Objectives Tumor‐infiltrating lymphocytes (TILs) have emerged as an efficient biomarker predicting treatment response and prognosis of breast cancer (BC). This study aimed to evaluate the association between conventional ultrasound and contrast‐enhanced ultrasound (CEUS) imaging features with TIL levels in invasive BC patients. Methods We retrospectively included 267 women with invasive BC who had undergone conventional ultrasound and CEUS. Patients were divided into low (≤10%) and high (>10%) TIL groups. Conventional ultrasound and CEUS features were analyzed by two sonographers. The associations between the TIL levels and imaging features were evaluated. Results Of the 267 patients, 122 with high TILs and 145 with low TIL levels. High TIL tumors were more likely to have a circumscribed margin, oval or round shape, and enhanced posterior echoes on ultrasonography (p < 0.05). In contrast, low TIL tumors were more likely to have an irregular shape, un‐circumscribed, indistinct and spiculated margin (p < 0.05). In CEUS, high TIL tumors showed a more regular shape, clearer margin, more homogeneous enhancement and higher peak intensity (PI) value (p < 0.05). Logistic analysis indicated that shape, posterior features, PI, and enhanced homogeneity were independent predictors for high TIL tumors. The model combined the four independent predictors have a moderate performance in predicting high TIL tumors with AUC 0.79, sensitivity 0.72, and specificity 0.78. Conclusions Conventional ultrasound and CEUS features were associated with TIL levels in invasive BC. Consequently, the results suggested that preoperative conventional ultrasound and CEUS may be a useful noninvasive imaging biomarker for individualized treatment decisions.

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Association Between Contrast‐Enhanced Ultrasound Characteristics and Molecular Subtypes of Breast Cancer

Cited by 11 publications

References 45 publications

Imaging features of breast cancer subtypes on contrast enhanced ultrasound: a feasibility study

Imaging features of breast cancer subtypes on contrast enhanced ultrasound: a feasibility study

Contrast-enhanced ultrasound for the preoperative prediction of pathological characteristics in breast cancer

Evaluating Tumor‐Infiltrating Lymphocytes in Breast Cancer

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