Ultrasound criteria for ductal invasive breast cancer are modified by age, tumor size, and axillary lymph node status.
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.
Watermann
Dirk O
DO
Gynecology and Obstetrics, Freiburg University Medical Center, Hugstetter Str. 55,79106, Freiburg im Breisgau, Germany. watermann@frk.ukl.uni-freiburg.de
Tempfer
Clemens B
CB
Hefler
Lukas A
LA
Parat
Celine
C
Stickeler
Elmar
E
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