title: Association between sonographic appearances of breast cancers and their histopathologic features and biomarkers.
abstract: OBJECTIVE
  The purpose of this study was to investigate potential associations between invasive breast cancer sonographic (US) findings and histopathologic patterns and biomarkers.
  
  
  METHODS
  One hundred consecutive women with invasive breast cancer treated in the Breast Diagnostic Center of Brotzu Hospital in Cagliari, Italy, from January to October 2013, were retrospectively evaluated. Two experienced breast radiologists independently evaluated hard copies of US examinations performed during the US-guided biopsy procedure. Tumor characteristics were assessed by using the BI-RADS US lexicon. For each patient, the results of histopathologic examination, tumor grading, hormone-receptor status, HER2, and Ki67 were considered. US characteristics were compared with histopathologic features and biomarkers. Statistical analysis was performed.
  
  
  RESULTS
  Low-grade tumors were statistically significantly associated with spiculated margins (p = 0.002) and hyperechoic halos (p < 0.001). High-grade tumors were associated with abrupt interfaces, nonspiculated margins, and absence of posterior acoustic shadowing. Malignant breast masses with spiculated margins were significantly associated with hormone-receptor positivity (p = 0.009). The most frequent tumor grade was G3 in the HER2 + and triple-negative subgroups. Patients with G3 tumors were significantly younger than those with G1 or G2 disease (51.3 ± 9.5 years versus 58.7 ± 12.6 years; p = 0.004).
  
  
  CONCLUSIONS
  Histopathologic patterns and breast cancer biomarkers determine differences in US imaging that can guide radiologists in better understanding the development of breast cancer and its prognosis.
authors.affiliation: Radiology Department, Brotzu Hospital, Piazzale A. Ricchi 1, 09134, Cagliari, Italy.
authors.forename: Melania
authors.initials: M
authors.lastname: Costantini
authors.affiliation: Radiology Department, Cattolica del Sacro Cuore University, Largo A. Gemelli 8, 00168, Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Belli
authors.affiliation: Radiology Department, Cattolica del Sacro Cuore University, Largo A. Gemelli 8, 00168, Rome, Italy.
authors.forename: Enida
authors.initials: E
authors.lastname: Bufi
authors.affiliation: Pathology Department, Brotzu Hospital, Piazzale A. Ricchi 1, 09134, Cagliari, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Asunis
authors.affiliation: Radiology Department, Brotzu Hospital, Piazzale A. Ricchi 1, 09134, Cagliari, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Ferra
authors.affiliation: Radiology Department, Brotzu Hospital, Piazzale A. Ricchi 1, 09134, Cagliari, Italy.
authors.forename: Grazia Tomasa
authors.initials: GT
authors.lastname: Bitti
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D015203:Reproducibility of Results; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor
keywords: biomarkers; breast cancer; sonographic features; ultrasonography