Breast cancer is a heterogeneous disease both in its clinical and radiological
manifestations and response to treatment. This is largely due to the polymorphism of the
histological types as well as diversified molecular profiles of individual breast cancer
types. Progress in the understanding of the biology of breast cancer was made with the
introduction of immunohistochemical research into the common practice. On this basis,
four main breast cancer subtypes were distinguished: luminal A, luminal B, HER2 positive
(human epidermal growth factor receptor-2 positive), and triple negative cancer. The
classification of a tumour to an appropriate subtype allows for the optimisation of
treatment (surgery or pre-operative chemotherapy). In this study, the authors present
different patterns of breast cancer subtypes in ultrasound examination and differences
in their treatment, with particular emphasis on aggressive breast cancer subtypes, such
as triple negative or HER2 positive. They can, unlike the luminal subtypes, create
diagnostic problems. Based on multifactorial analysis of the ultrasound image, with the
assessment of lesion margins, orientation, shape, echogenicity, vascularity, the
presence of calcifications or assessment by sonoelastography, it is possible to
initially differentiate individual subtypes.