Systematic Review and Meta‐analysis of the Malignant Ultrasound Features of Triple‐Negative Breast Cancer

Abstract

Objectives-The malignant ultrasound (US) features of breast cancer are known to include an irregular shape, a noncircumscribed margin, an echogenic halo, a nonparallel orientation, posterior acoustic attenuation, microcalcification, and others. However, these US features are uncertain and controversial for the diagnosis of triple-negative breast cancer (TNBC). This study aimed to analyze the diagnostic value of malignant US features for TNBC by a systematic review and meta-analysis, analyze the US characteristics of TNBC, and provide US evidence for clinical diagnosis. Methods-A comprehensive search was performed to identify relevant English articles concerning the US diagnosis of TNBC (from the date of database establishment to November 2019). The pooled sensitivity, pooled specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio with 95% confidence interval, summary receiver operating characteristic curve, and area under the curve for the different malignant US features were calculated. Results-Ten studies (620 patients) met the eligibility criteria. The sensitivity (range, 0.14-0.68) and specificity (range, 0.19-0.66) of the malignant US features were not high. Summary receiver operating characteristic curves showed that the area under the curve (range, 0.25-0.47) of the malignant US features was low, demonstrating that these features have poor diagnostic value for TNBC. The positive likelihood ratio (range, 0.4-to 0.9) of the malignant US features was low, and the negative likelihood ratio (range, 1.09-2.02) was not low, revealing that these features had a poor ability to confirm or exclude TNBC. Conclusions-Triple-negative breast cancer lacks the typical malignant US features of breast cancer and has its own US features. Key Words-malignant ultrasound features; meta-analysis; systematic review; triple-negative breast cancer B reast cancer is one of the most common malignant tumors in women. Its incidence is rapidly rising in most countries. 1-3 Triple-negative breast cancer (TNBC) is a distinct subtype of breast cancer that lacks the estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 and is characterized by high malignancy, poor tissue differentiation, and strong invasive ability. 4-6 Therefore, the early diagnosis of TNBC is very important to provide appropriate therapy. Endocrine therapies and targeted therapies are ineffective for TNBC. Some studies have shown that patients with TNBC are more likely to have a complete pathologic response with neoadjuvant chemotherapy than those without TNBC. 7,8 At present, the diagnosis of

Radiologic-pathologic correlation in breast cancer: do MRI biomarkers correlate with pathologic features and molecular subtypes?

“…Triple negative BCs are biologically and clinically aggressive tumours with peculiar imaging features, on both conventional breast imaging (frequently mimicking benign lesions [47][48][49]) and MRI. In our study, triple negative BCs were predominantly masses (81.1%), characterised by round shape (86.7%), non-circumscribed margins (90%) and rim enhancement (73.3%).…”

Calcification, Posterior Acoustic, and Blood Flow: Ultrasonic Characteristics of Triple-Negative Breast Cancer

“…ereafter, several studies analyzing the US characteristics of TNBC have been carried out in China [15][16][17][18], Japan [19], and South Korea [20,21]. Recently, Tian et al [22] reviewed studies based on the US features of TNBC. In the meta-analysis, only 620 patients with TNBC in ten clinical studies were included [22].…”

Application value of conventional ultrasound combined with shear wave elastography in diagnosing triple negative breast cancer

“…Ultrasound diagnostic capability is impaired by associated benign features encountered in 21-41% of TNBC lesions (10). Triple-negative breast cancer lacks the typical malignant US features of breast cancer (11).The TNBC manifestations of 2-dimensional (2D) ultrasound (US) and US elastography have particular characteristics, which have significance in distinguishing TNBC from non-TNBC, but color Doppler flow imaging (CDFI) shows that the blood flow signals of TNBC and non-TNBC are similar. There are few reports on the differential diagnosis of TNBC and non-TNBC by contrast-enhanced US and 3D ultrasound.…”