Application of Contrast-Enhanced Ultrasound in the Differential Diagnosis of Different Molecular Subtypes of Breast Cancer

2020 ◽  
Vol 42 (6) ◽  
pp. 261-270
Author(s):  
Xingyu Liang ◽  
Ziyao Li ◽  
Lei Zhang ◽  
Dongmo Wang ◽  
Jiawei Tian
Keyword(s):  
Breast Cancer ◽  
Contrast Enhancement ◽  
Triple Negative ◽  
Breast Lesions ◽  
Luminal Epithelium ◽  
Enhancement Pattern ◽  
Over Expression ◽  
Contrast Enhanced ◽  
Her 2 ◽  
Triple Negative Subtype

To explore the value of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of molecular subtypes of breast cancer. Sixty-two cases of breast cancer were divided into luminal epithelium A or B subtype (luminal A/B), Her-2 over-expression subtype and triple negative subtype (TN). CEUS and routine ultrasonography were performed for all patients before surgery. (1) The luminal epithelium subtype contrast enhancement pattern was more likely to present with radial edge (76.92%, p < 0.05) and low perfusion (69.23%, p < 0.05). The maximum intensity (IMAX) was lower in the luminal epithelium subtype ( p < 0.05). (2) The Her-2 over-expression subtype contrast enhancement pattern was more likely to present with centripetal enhancement (93.75%, p < 0.05) and perfusion defect (75.0%, p < 0.05), and the time to peak (TTP) was shorter (80.0%, p < 0.05). (3) The contrast enhancement pattern of the triple negative subtype was shown to have a clear boundary. Compared to the other two subtypes, the triple negative subtype did not have significantly different perfusion parameters ( p > 0.05). (4) Our study showed that the areas under the ROC curve for radial edge, low perfusion and IMAX for the luminal epithelium subtype breast lesions were 76.5%, 75.6%, and 82.1%, respectively. Additionally, the areas under the ROC curve for centripetal enhancement, perfusion defect and TTP for the Her-2 over-expression subtype breast lesions were 68.6%, 92.4%, and 97.8%, respectively. The sensitivity, specificity, and diagnostic accuracy of clear boundaries in detecting triple negative subtype breast lesions were 90.5%, 80.0%, and 91.9%, respectively.

scholarly journals Differential Diagnosis of Breast Lesions in Dual-Energy Contrast-Enhanced Spectral Mammography

2021 ◽  
pp. 1-6
Author(s):  
Antonina V. Chernaya ◽  
Antonina V. Chernaya ◽  
Roksana H. Ulyanova ◽  
Petr V. Krivorotko ◽  
Sergey N. Novikov ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Contrast Enhancement ◽  
Diagnostic Performance ◽  
Dual Energy ◽  
Diagnostic Feature ◽  
Breast Lesions ◽  
Benign Lesions ◽  
Enhancement Pattern ◽  
Contrast Enhanced ◽  
Detailed Assessment

Background: Dual-energy contrast-enhanced spectral mammography (CESM) is one of the latest methods for breast lesions characterization, where structural and functional (i.e., vascularization) assessment are combined. Nowadays an interpretation of contrast-enhanced images is based only on the degree of contrast enhancement, but we propose a more detailed assessment of the structure of the hypervascular lesions by highlighting the contrast enhancement patterns. Purpose: To evaluate the diagnostic performance of contrast-enhanced spectral mammography (CESM) using the contrast enhancement patterns in malignant and benign lesions. Material and Methods: Study included 332 women examined from February 2018 to June 2020. The mean age of the women was 50 years. Of 428 lesions totally revealed, 172 (40.2%) were histologically verified as malignant and 256 (59.8%) as benign. We proposed 9 types of contrast enhancement patterns to describe lesions: reticular, granular, annular, diffuse-spherical, lacunar, cloud-like, heterogeneous-annular, point, cotton-like. Results: We showed that diagnostic performance of CESM increased sensitivity if an additional diagnostic feature of contrast enhancement pattern was used: sensitivity increased from 79.7% to 94.8% (p = 0.26), specificity from 82.4% to 95.3% (p = 0.013) and accuracy from 81.3 to 95.1% (p = 0.004), in comparison with using of only one feature of contrast enhancement intensity in the differential diagnosis of malignant and benign lesions. Conclusion: Thus, using contrast enhancement pattern allows to increase the efficiency of CESM in breast cancer detection.

scholarly journals Contrast-enhanced ultrasound of breast fibromatosis: a case report

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110106
Author(s):  
Shanhong Lin ◽  
Yong Cao ◽  
Libin Chen ◽  
Mei Chen ◽  
Shengmin Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Rare Case ◽  
Common Type ◽  
Breast Lesions ◽  
Contrast Enhanced Ultrasound ◽  
High Similarity ◽  
Potential Value ◽  
Contrast Enhanced ◽  
Malignant Breast ◽  
Contrast Enhanced Ultrasonography

We herein present a rare case of breast fibromatosis, the contrast-enhanced ultrasonography (CEUS) findings of which we believe have never been described. The high similarity between the clinical and imaging manifestations of breast cancer makes its differential diagnosis difficult. In this report, we describe the CEUS findings of a less common type of fibromatosis, discuss the potential value of CEUS to differentiate it from malignant breast lesions, and briefly review the literature.

scholarly journals Reproductive and hormonal risk factors for postmenopausal luminal, HER-2-overexpressing, and triple-negative breast cancer

Cancer ◽  
2008 ◽  
Vol 113 (7) ◽  
pp. 1521-1526 ◽  
Author(s):  
Amanda I. Phipps ◽  
Kathleen E. Malone ◽  
Peggy L. Porter ◽  
Janet R. Daling ◽  
Christopher I. Li
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Her 2

scholarly journals How shall we treat locally advanced triple negative breast cancer?

F1000Research ◽  
2020 ◽  
Vol 8 ◽  
pp. 1649
Author(s):  
Paulo Luz ◽  
David Dias ◽  
Ana Fortuna ◽  
Luis Bretes ◽  
Beatriz Gosalbez
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Locally Advanced ◽  
Surrogate Marker ◽  
Metastatic Breast ◽  
Complete Response ◽  
Number Of Patients ◽  
Her 2 ◽  
Near Future

Triple negative breast cancer (TNBC) has been shown to respond to neoadjuvant chemotherapy (NACT). It has been established that achieving pathological complete response (pCR) for certain aggressive subtypes of breast cancer, including HER-2 (over-expressed) and TNBC, provides an important surrogate marker for predicting long-term clinical response and survival outcomes. How to increase the number of patients that achieve pCR remains challenging. Platinum-based NACT seems to be part of the solution and capecitabine, an active drug in metastatic breast cancer, but not a standard one in earlier stages may have found its place in the adjuvant setting. In the near future immunotherapy can play a role in early TNBC

scholarly journals Antiangiogenic therapy for breast cancer with triple negative phenotype

2021 ◽  
Vol 23 (1) ◽  
pp. 88-92
Author(s):  
Inna P. Ganshina ◽  
Kristina A. Ivanova ◽  
Olga O. Gordeeva ◽  
Aleksandr V. Arkhipov ◽  
Liudmila G. Zhukova
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Malignant Tumors ◽  
Antiangiogenic Therapy ◽  
Treatment Strategies ◽  
Her 2 ◽  
Triple Negative Phenotype ◽  
The Impact ◽  
Negative Phenotype

Triple-negative breast cancer is 1024% of all cases of breast cancer and is characterized by the absence of estrogen, progesterone, and HER-2 receptors in the tumor. The therapy of this illness is a difficult clinical case. In contrast to hormone-positive and HER-2-positive phenotypes, in which we successfully use targeted drugs (antiestrogens and anti-HER-2 drugs), for triple-negative breast cancer we have not had such targets for a long time. Thus, despite the impressive results of immunotherapy of triple-negative breast cancer, there remains a fairly large group of patients with negative PD-L1 status, for whom it is necessary to develop other treatment strategies. One of the approaches in the treatment of malignant tumors includes not the impact on tumor cells, but the process of angiogenesis. Antiangiogenic drugs have positively proven themselves in the treatment of a large number of malignant tumors but are underestimated for breast cancer (including triple-negative phenotype). The use of bevacizumab in combinations with cytostatic drugs in breast cancer therapy (including triple-negative breast cancer) has been studied in a large number of clinical trials but was undeservedly forgotten in some countries due to the revoked FDA registration. This review presents the role of bevacizumab in the treatment of patients with triple-negative breast cancer and suggests the conditions when the administration of this drug is justified and leads to better results.

scholarly journals DIFFERENTIAL DIAGNOSTICS OF BREAST PATHOLOGY USING CONTRAST ENHANCEMENT PATTERNS IN CONTRAST-ENHANCED SPECTRAL MAMMOGRAPHY

2020 ◽  
Vol 66 (3) ◽  
pp. 252-261
Author(s):  
Roksana Ulyanova ◽  
A. Chernaya ◽  
Petr Krivorotko ◽  
Sergey Novikov ◽  
Sergey Kanaev ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Contrast Enhancement ◽  
World Literature ◽  
Differential Diagnostics ◽  
Diagnostic Feature ◽  
Benign Lesions ◽  
Intravenous Contrast ◽  
Dynamic Contrast Enhancement ◽  
Contrast Enhanced ◽  
Detailed Assessment

Dual-energy contrast-enhanced spectral mammography (CESM) is a new promising method for visualizing pathological changes in breast, which combines digital mammography and a functional assessment of vascularization using intravenous contrast ehnancement. According to accumulated experience CESM is well tolerated by patients and is similar to magnetic resonance imaging with dynamic contrast enhancement (MRI with DCE), but at the same time, CESM is more affordable and can be performed in patients with contraindications for MRI. However, few studies have been conducted to evaluate the role of CESM. In the world literature, interpretation of contrast images is based only on the degree of accumulation of the contrast agent, but we propose a more detailed assessment of the structure of the hypervascular lesions by highlighting the contrast enhancement patterns. Objective: to determine the diagnostic effectiveness of CESM using the contrast enhancement patterns in malignant and benign lesions. Materials and methods. 239 women with suspicious for breast cancer lesions were examined from August 2018 to December 2019. The mean age of the women was 51 years. 322 lesions were revealed, 149 (46.3%) were malignant, 173 (53.7%) were benign. All lesions were histologically confirmed. As a result of the analysis of our data, 9 types of contrast enhancement patterns were distinguished: reticulate, granular, annular, diffuse-spherical, lacunar, cloud-like, heterogeneous-annular, point, cotton-like. Results. Using an additional diagnostic feature - contrast enhancement patterns in lesions, increased the sensitivity of CESM from 91.3% to 98.0% (p=0.26), specificity from 80.3% to 93, 6% (p=0.013), accuracy from 85.4 to 95.7% (p=0.004) in comparison with using of only one feature of contrast enhancement intensity in the differential diagnosis of malignant and benign lesions. Conclusion: thus, this approach of interpreting subtraction images allows to increase the efficiency of CESM in diagnosis of breast cancer.

scholarly journals Comparing MicroRNA Profilings of Purified HER-2-Negative and HER-2-Positive Cells Validates miR-362-5p/Sema3A as Characteristic Molecular Change in Triple-Negative Breast Cancers

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Xiaoqing Zhang ◽  
Qi He ◽  
Leiqin Sun ◽  
Yanfei Zhang ◽  
Shengying Qin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Protein Expression ◽  
Real Time ◽  
Differential Expression ◽  
Real Time Pcr ◽  
Therapeutic Target ◽  
Triple Negative ◽  
Quantitative Real Time Pcr ◽  
Her 2 ◽  
Tnbc Subtype

Background. HER-2 is a key molecule serving as the therapeutic target, prognostic biomarker, and classification marker in breast cancer. Accurate microRNA profilings had not been conducted in purified tumor cells of HER-2-negative and HER-2-positive tissue specimens obtained from breast cancer patients. Methods. (i) Differential expression microRNA discovery using laser capture microdissection- (LCM-) assisted specimen preparation and microRNA array chips on HER-2 overexpressing and triple-negative breast carcinoma (TNBC) subtype tissues, (ii) differential expression microRNA validation by quantitative real-time PCR, and (iii) independent validation on tissue microarray. Results. Five microRNAs (miR-20a-5p, miR-221-3p, miR-362-5p, miR-502-3p, and miR-222-3p) were screened and validated as upregulated microRNAs in TNBC cells comparing to HER-2 overexpressing cells using a microRNA array (5 cases in each group) and quantitative real-time PCR (20 cases in each group). The expression difference of miR-362-5p had the most significant statistical significance (p=0.0016) among the five microRNAs. The expression of miR-362-5p and its target gene Sema3A was further analyzed using in situ hybridization (ISH) and immunohistochemistry on standard tissue sections (n=150). 70.8% of HER-2-negative cells showed moderate expression of miR-362-5p whereas 20.4% HER-2-negative cells correlated with strong expression of miR-362-5p (p<0.0001). The proportion of patients with moderate/strong miR-362-5p expression in luminal, HER-2 overexpressing, and TNBC subtypes were 53.2%, 22.2%, and 74.3%, respectively (p=0.0002). High miR-362-5p expressers had shorter overall survival in the univariate analysis (p=0.046). There was a significant negative correlation between miR-362-5p and Sema3A expression (p<0.0001). The patients with negative/weak Sema3A protein expression had poorer prognosis than those with moderate (HR: 3.723, p=0.021) or strong (HR: 3.966, p=0.013) Sema3A protein expression in the multivariate analysis. Conclusions. miR-362-5p/Sema3A might provide a promising therapeutic pathway and represents a candidate therapeutic target of the TNBC subtype.

scholarly journals BIRADS 4 breast lesions: comparison of contrast-enhanced spectral mammography and contrast-enhanced MRI

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Rabab Yasin ◽  
Enas Abd El Ghany
Keyword(s):  
Breast Cancer ◽  
Developing Countries ◽  
Statistical Significance ◽  
Breast Mri ◽  
Excision Biopsy ◽  
Breast Lesions ◽  
Common Cancer ◽  
Contrast Enhanced ◽  
Histopathological Result ◽  
Contrast Enhanced Mri

Abstract Background Breast cancer is the most common cancer in women worldwide. It is responsible for about 23% of cancer in females in both developed and developing countries [1]. We aimed to assess the accuracy of contrast-enhanced spectral mammography (CESM) versus contrast-enhanced breast MRI in the evaluation of BIRADS 4 breast lesions. Results Fifty patients were included in this study; there were 28 malignant cases and 22 benign cases; all cases were proved by histopathological result either by core biopsy or excision biopsy. CESM was found to have less sensitivity (94.1%) than MRI (100%) but CESM has higher specificity (100%) than MRI (95.5%). The accuracy of CESM was 96.4%, while the accuracy of MRI was 98.2% with no statistical significance (P value 0.827). Conclusion CESM can be used as a sensitive diagnostic tool in the detection and staging of breast cancer with higher specificity and less sensitivity as compared to contrast enhanced breast MRI.

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