title: Ultrasound criteria for ductal invasive breast cancer are modified by age, tumor size, and axillary lymph node status.
abstract: OBJECTIVE
  To evaluate the influence of distinct clinicopathological parameters on ultrasound criteria for ductal invasive breast cancer.
  
  
  METHODS
  The hardcopy prints of 337 ductal invasive breast cancers were analyzed. Ten ultrasound criteria (shape, orientation, echogenicity, echo pattern, calcifications, margin, margin contour, lesion boundary, surrounding tissue, and posterior acoustic features) were defined and correlated to age, tumor size, axillary lymph node status, and histological grading in a multivariate analysis.
  
  
  RESULTS
  Tumors in women < or = 50 years displayed more often an indistinct margin (p = 0.003) and an enhanced/indifferent posterior ultrasound transmission (p = 0.008). Tumors in an advanced T-stage showed more frequently an irregular shape ( p = 0.006), an orientation parallel to the skin ( p = 0.01), hypoechogenicity ( p < 0.0001), and less often calcifications ( p = 0.002). A positive axillary lymph node status was significantly correlated to oval/round shape ( p = 0.004), hyper-/isoechogenicity ( p = 0.001), and a homogeneous echo pattern ( p = 0.002). Grading showed no correlation to the examined ultrasound criteria.
  
  
  CONCLUSIONS
  Breast ultrasound criteria, which are used to differentiate benign from malignant breast lesions, are influenced by age, size and lymph node status. These clinical conditions should be considered in the ultrasound diagnosis of breast lesions.
authors.affiliation: Gynecology and Obstetrics, Freiburg University Medical Center, Hugstetter Str. 55,79106, Freiburg im Breisgau, Germany. watermann@frk.ukl.uni-freiburg.de
authors.forename: Dirk O
authors.initials: DO
authors.lastname: Watermann
authors.forename: Clemens B
authors.initials: CB
authors.lastname: Tempfer
authors.forename: Lukas A
authors.initials: LA
authors.lastname: Hefler
authors.forename: Celine
authors.initials: C
authors.lastname: Parat
authors.forename: Elmar
authors.initials: E
authors.lastname: Stickeler
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging* / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging / Q000379:methods*; D012016:Reference Values; D012189:Retrospective Studies; D014463:Ultrasonography