title: Correlation of sonographic features of invasive ductal mammary carcinoma with age, tumor grade, and hormone-receptor status.
abstract: OBJECTIVE
  To determine whether presenting sonographic features of invasive ductal carcinomas (IDC) are associated with patient age, tumor histologic grade, and hormonal receptor status.
  
  
  METHODS
  Sonographic features of 101 consecutive cases of IDC seen at ultrasound were retrospectively assessed based on the BI-RADS criteria of posterior acoustic appearance, tumor margins, and echogenicity. Associations between sonographic features and tumor characteristics were statistically evaluated with attention to patient age.
  
  
  RESULTS
  IDC with shadowing compared with unchanged posterior acoustic appearance were significantly more likely to be of low histologic grade (Odds Ratio [OR] = 5.00; p < 0.05) and estrogen receptor (ER) -positive (OR = 10.00; p < 0.05). Conversely, posterior enhancement was associated with ER-negative status (OR = 4.45; p < 0.01), particularly among patients younger than 60 years of age (OR = 5.36, p < 0.05). Circumscribed tumors were more often high grade, particularly among older women (p < 0.01), and hormone receptor--negative regardless of age group. Among older women, tumors with mixed echogenicity tended to be high grade and progesterone receptor--negative (p values < 0.05). Noncircumscribed borders were observed for all tumors with posterior shadowing, and 97% of such tumors were also ER positive.
  
  
  CONCLUSIONS
  Sonographic features were significantly associated with tumor grade and hormone receptor status, with some differences based on patient age. Specifically, the presence of posterior shadowing was associated with lower histologic grade and ER-positive status, especially in older patients. In contrast, we found that posterior acoustic enhancement was more commonly associated with ER-negative status, especially in younger patients.
authors.affiliation: Department of Radiology, Medical University of South Carolina, Charleston, South Carolina 29403, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Aho
authors.forename: Abid
authors.initials: A
authors.lastname: Irshad
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Ackerman
authors.forename: Madelene
authors.initials: M
authors.lastname: Lewis
authors.forename: Rebecca
authors.initials: R
authors.lastname: Leddy
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Pope
authors.forename: Amy S
authors.initials: AS
authors.lastname: Campbell
authors.forename: Abbie
authors.initials: A
authors.lastname: Cluver
authors.forename: Bethany J
authors.initials: BJ
authors.lastname: Wolf
authors.forename: Joan E
authors.initials: JE
authors.lastname: Cunningham
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D011960:Receptors, Estrogen / Q000378:metabolism*; D011980:Receptors, Progesterone / Q000378:metabolism*; D012189:Retrospective Studies; D016217:Ultrasonography, Mammary / Q000379:methods*
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone