Chinese Clinical Oncology

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Correlation between image characteristics of intrinsic subtypes of breast cancer and resection rate of breast conserving surgery

ZHAO Kaihua, LI Peiying, TAN Zhengshuai, LI Zhenfeng, FANG Kun, GONG Lei, LIU Songling, WANG Binggao, YAN Zheng.
  

  1. Department of Breast Surgery,the Second Clinical Medical College of Qingdao University
  • Received:2017-02-10 Revised:2017-05-22 Online:2017-07-31 Published:2017-07-31
  • Contact: YAN Zheng

Abstract: Objective To investigate the correlation between the image features associated with the intrinsic subtypes of breast cancer and resection rate of breast conserving surgery. Methods Two hundred and twenty cases with palpable mass and non specific breast cancer in stage Ⅰ-Ⅱ were divided into Luminal A(n=32), Luminal B(n=75), Luminal HER-2(n=38), HER-2enriched(n=33) and triple negative breast cancer(TNBC, n=42) according to the histopathology and immunohistochemistry examination, who were performed core needle biopsy before sugery. According to the mammography images with BIRADS classification standard, mammogram features were divided into five groups, including masses types, calcification types, asymmetries types, architectural distortion types and spicule sign. The cutting edge was 1 cm apart from the mass. Frozen scection analysis was used to assess the margin status during the operation, which was confirmed by paraffin pathology diagnosis after surgery. Combining with intrinsic subtypes, we analyzed the correlation of imaging features of breast cancer and re-excision efficacy of breastconserving surgery.
ResultsAmong the five groups, single imaging signs of breast cancer occupied 37.5%(12/32), 29.3%(22/75), 28.9%(11/38), 15.2%(5/33) and 61.9%(26/42),mixture imaging signs of breast cancer occupied 62.5%(20/32),70.7%(53/75),71.1%(27/38),84.8%(28/33) and 38.1%(16/42),respectively, and the difference was statistically significant(P<0.001). The edge signs of breast cancer (spiculated signs) occupied 50.0%(16/32),42.7%(32/75),50.0%(19/38),18.2%(6/33) and 7.1%(3/42) respectively. The difference was statistically significant(P<0.001). The reexcision rate after breastconserving surgery were 12.5%(4/32),9.3%(7/75),21.1%(8/38),18.2%(6/33) and 0(0/42) respectively. The difference was statistically significant(P<0.001). If the imaging features include two or more kinds of imaging signs, HER-2 express status was significant correlated with re-excision rates(P=0.001). Conclusion Intrinsic subtypes, mammogram features and cuttingedge signs of non-specific breast cancer should be considered for breastconserving surgery in order to reduce the probability of reexcision.

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