Retrospective Analysis of the Clinicopathological Features of False Negative Breast Cancer with Ultrasound BI-RADS Classification
- VernacularTitle:超声BI-RADS 分级假阴性乳腺癌临床病理特征的回顾性分析
- Author:
Ying WU
1
;
Kun-he WU
1
;
Yue-xian LING
1
;
Yu-juan GUO
1
;
Hong-yi GAO
1
Author Information
1. Department of Pathology, Guangdong Women and Children Hospital, Guangzhou 511400, China
- Publication Type:Journal Article
- Keywords:
breast cancer;
false negative;
breast ultrasound;
BI-RADS;
clinical pathology
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2020;41(4):635-643
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To retrospectively analyze the differences of clinicopathological parameters and molecular biological characteristics between ultrasound false negative and true positive breast cancer cases and summarize the clinical characteristics of these cases. 【Methods】 A total of 414 invasive breast cancer cases in Guangdong Women and Children Hospital between January 1st, 2018 and December 31st, 2019 were enrolled in this study. According to the BI-RADS classification standard of ultrasound, they were divided into false negative group and true positive group. The differences of onset age, tumor size, tumor histological grade, lymph node metastasis, estrogen receptor(ER), progesterone receptor (PR), human epidermal growth factor receptor(HER2), Ki-67, fiber reaction, vascular hyperplasia, lymphocyte infiltration and necrosis between the two groups were compared and analyzed. The differences with statistical significance were analyzed by multivariate logistic regression analysis. 【Results】 These 414 invasive breast cancer cases were composed of 43 false negative cases and 371 true positive cases. There was no significant difference in histopathological type between the two groups(P = 0.250). In the false negative group, the rate of luminal A(32.6%) and basal-like(27.9%) cases was respectively higher than that of the true positive group(17.8%, 14.3%), whereas the rate of HER2 overexpression (6.9%) cases was lower than that of the true positive group(32.1%), with statistical significance(P < 0.05). The rate of luminal B cases in the false negative group(32.6%) was not significantly different from that in the true positive group (35.8%, χ2 = 0.182, P = 0.669). Compared with the true positive group, there was no significant difference in tumor histological grade(χ2 = 5.129, P = 0.077), ER expression(χ2 = 1.666, P = 0.197), PR expression(χ2 = 0.290, P = 0.590), HER2 expression(χ2 = 3.378, P = 0.066), fiber reaction(χ2 = 5.353, P = 0.069), lymphocyte infiltration(χ2 = 2.023, P = 0.155) and necrosis(χ2 = 0.468, P = 0.494), whereas the differences of the tumor size(P < 0.001), lymph node metastasis(χ2 = 43.184, P < 0.001), Ki-67 expression(χ2 = 9.293, P = 0.010), age(χ2 = 10.334, P = 0.006) and vascular hyperplasia(χ2 = 5.937, P = 0.015) were statistically significant. In the false negative group, the rate of tumor size ≤ 2 cm(81.4%, 35/43 vs. 33.7%, 125/371), no lymph node metastasis(97.7%, 42/43 vs. 44.7%, 166/371), Ki-67 expression > 70%(18.6%, 8/43 vs. 5.9%, 22/371), age ≤ 45 years(65.1%, 28/43 vs. 41.2%, 153/371) and vascular hyperplasia number ≤ 3(74.4%, 32/43 vs. 55.0%, 204/371) were higher than that in the true positive group, respectively. Multivariate logistic regression analysis showed that only tumor size ≤ 2 cm(OR = 6.791, P < 0.001) and no lymph node metastasis(OR = 43.333, P < 0.001) were independent risk factors for the false negative ultrasound results. 【Conclusions】 Luminal A and HER2 overexpression breast cancer cases are easier to be underestimated by ultrasound BI-RADS classification. Patients with tumor size ≤ 2 cm and no lymph node metastasis are prone to have false negative breast ultrasound results, which should be regarded with more care.
