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There are few radiogenomic studies to correlate ultrasound features of breast cancer with genomic changes. We investigated whether vascular ultrasound phenotypes are associated with breast cancer gene profiles for predicting angiogenesis and prognosis. We prospectively correlated quantitative and qualitative features of microvascular ultrasound (vascular index, vessel morphology, distribution, and penetrating vessel) and contrast-enhanced ultrasound (time–intensity curve parameters and enhancement pattern) with genomic characteristics in 31 breast cancers. DNA obtained from breast tumors and normal tissues were analyzed using targeted next-generation sequencing of 105 genes. The single-variant association test was used to identify correlations between vascular ultrasound features and genomic profiles. Chi-square analysis was used to detect single nucleotide polymorphisms (SNPs) associated with ultrasound features by estimating p values and odds ratios (ORs). Eight ultrasound features were significantly associated with 9 SNPs (p ERBB2 (p = 0.04, OR = 7.75); large area under the curve on contrast-enhanced ultrasound with rs35597368 in PDGFRA (p = 0.04, OR = 4.07); high peak intensity with rs35597368 in PDGFRA (p = 0.049, OR = 4.05) and rs2305948 in KDR (p = 0.04, OR = 5.10); and long mean transit time with rs2275237 in ARNT (p = 0.02, OR = 10.25) and rs755793 in FGFR2 (p = 0.02, OR = 10.25). We identified 198 non-silent SNPs in 71 various cancer-related genes. Vascular ultrasound features can reflect genomic changes associated with angiogenesis and prognosis in breast cancer.

To compare the diagnostic performances of tomosynthesis and ultrasonography as adjunctives to digital mammography in women with dense breasts.A total of 778 women with dense breasts underwent digital mammography with tomosynthesis and ultrasonography for screening and diagnostic purposes. The findings of tomosynthesis and ultrasonography were evaluated independently. The primary endpoint was overall diagnostic accuracy determined by area under the receiver operating characteristic curve (AUC). Secondary endpoints included sensitivity, specificity, and predictive values.Of the 778 participants, 698 women (140 breast cancers) were included in the analysis. Based on the AUC findings, the non-inferiority of tomosynthesis to ultrasonography was established in the overall group as well as in all subgroups except for that comprising women with extremely dense breast composition. There were no significant differences in AUC between tomosynthesis and ultrasonography among asymptomatic participants and participants who underwent imaging for screening (0.912 vs. 0.934 [P = 0.403] and 0.987 vs. 0.950 [P = 0.270], respectively). Tomosynthesis exhibited lower sensitivity (91.4 vs. 96.4%; P = 0.039), and higher specificity (83.9 vs. 70.4%; P 0.001) and positive predictive value (58.7 vs. 45.0%; P 0.001) than ultrasonography.Tomosynthesis exhibits comparable performance to ultrasonography as an adjunct to mammography for diagnosis of breast cancer, except among women with extremely dense breasts.

Our aim was to determine whether triple-negative breast cancers (TNBCs) with and without androgen receptor (AR) expression have distinguishing imaging features on mammography, breast ultrasound (US), and magnetic resonance (MR) imaging.AR expression was assessed immunohistochemically in 125 patients with TNBC from a consecutive series of 1,086 operable invasive breast cancers. Two experienced radiologists blinded to clinicopathological findings reviewed all imaging studies in consensus using the BI-RADS lexicon. The imaging and pathological features of 33 AR-positive TNBCs were compared with those of 92 AR-negative TNBCs.The presence of mammographic calcifications with or without a mass (p 0.001), non-mass enhancement on MR imaging (p 0.001), and masses with irregular shape or spiculated margins on US (p 0.001 and p = 0.002) and MR imaging (p = 0.001 and p 0.001) were significantly associated with AR-positive TNBC. Compared with AR-negative TNBC, AR-positive TNBC was more likely to have a ductal carcinoma in situ component (59.8% vs. 90.9%, p = 0.001) and low Ki-67 expression (30.4% vs. 51.5%, p = 0.030).AR-positive and AR-negative TNBCs have different imaging features, and certain imaging findings can be useful to predict AR status in TNBC.• Triple-negative breast cancers have distinguishing imaging features according to AR expression. • AR-positive TNBC is associated with calcifications, spiculated masses, and non-mass enhancement. • Multimodality imaging can help predict androgen receptor status in TNBC.

To evaluate whether tumour stiffness on sonoelastography is associated with axillary nodal metastasis in T1 breast carcinoma patients. Between May 2006 and December 2010, 200 consecutive women (mean age, 51.6; range, 27 – 81 years) who underwent B-mode ultrasound (US), sonoelastography, and curative surgery with axillary nodal evaluation for clinically node negative T1 breast carcinomas (mean invasive tumour size, 12.4; range, 3 – 20 mm at pathology) were identified. The association between the elasticity score of the tumour and histopathological axillary nodal status was evaluated using a logistic regression model after controlling for imaging and clinicopathological variables of the tumour. The overall incidence of axillary nodal metastasis was 15.5 % (31 of 200). Axillary nodal metastasis was significantly more frequent in tumours with elasticity scores ≥4 than in tumours with elasticity scores 10 mm (OR, 5.98; P = 0.022), and lymphovascular invasion (OR, 10.68; P < 0.001) of tumours were independently associated with axillary nodal metastasis. Tumour stiffness on sonoelastography is independently associated with axillary nodal metastasis in T1 breast carcinoma patients. • Prediction of axillary nodal status using imaging techniques is valuable. • High ultrasound elasticity scores of T1 tumours were associated with axillary metastasis • Node-positive T1 tumours frequently had elasticity scores 4 or 5. • Sonoelastography might render axillary surgery unnecessary in T1 breast carcinoma patients.

To evaluate the correlation between stiffness values obtained by shear-wave elastography (SWE) and breast cancer subtypes. This was an institutional review board-approved retrospective study with a waiver of informed consent. The stiffness of 337 invasive breast cancers in 337 women was evaluated by SWE and mean stiffness values (kPa) and qualitative colour scores (1–5) of tumours were obtained. The results were analysed according to BI-RADS category, tumour size, grade and tumour subtype (triple-negative [TN], human epidermal growth factor receptor 2 [HER2]-positive, and oestrogen receptor [ER]-positive) using a multiple linear regression analysis. The mean stiffness values and colour scores were: 146.8 kPa ± 57.0 and 4.1 ± 1.1; 165.8 kPa ± 48.5 and 4.6 ± 0.7 for TN tumours (n = 64), 160.3 kPa ± 56.2 and 4.3 ± 1.0 for HER2-positive tumours (n = 55) and 136.9 kPa ± 57.2 and 4.0 ± 1.1 for ER-positive tumours (n = 218; P < 0.0001). All three breast cancers classified as BI-RADS category 3 on B-mode ultrasound were TN subtype. A multiple linear regression analysis revealed that tumour size, histological grade and tumour subtype were independent factors that influenced the stiffness values. High stiffness values correlated with aggressive subtypes of breast cancer. • Shear-wave elastography is increasingly used to measure the stiffness of breast tumours. • Triple-negative and HER2-positive tumours showed greater stiffness than ER-positive tumours. • All breast cancers classified as BI-RADS 3 on B-mode ultrasound were triple-negative subtype. • Tumour size, histological grade and subtype were independent factors influencing SWE stiffness.

Ultrasonographic (US) assessment of breast density has the potential to provide a nonionizing method. This study was to prospectively evaluate intermodality and interobserver agreements for assessment of breast density between US and mammography. Institutional review board approval was obtained. Forty-one women (mean 52.1 years; range 25-72 years) with variable breast density consented to participate. Eight radiologists blinded to mammographic information performed breast US for all participants and assessed each breast density using four categories based on the proportion of the breast occupied by the fibroglandular tissue. All participants underwent full-field digital mammography and mammographic density was independently assessed by eight radiologists 2 weeks after US using the breast imaging reporting and data system (BI-RADS) 4-category system. Intermodality agreements between US and mammographic assessments and interobserver agreements among radiologists were assessed using kappa statistics (к) and intraclass correlation coefficients (ICCs). There was substantial intermodality agreement between the US and mammographic assessments of breast density (к = 0.65 and ICC = 0.80), and 68 % (222/328) of the assessments had exact agreement. When categories were dichotomized into fatty (categories 1 and 2) and dense (categories 3 and 4), 86 % (282/328) of the assessments had exact agreement (к = 0.71). The interobserver agreement for the US assessments of breast density was substantial (average к = 0.63, ICC = 0.82) and not significantly different from that for the mammographic assessments (average к = 0.74, ICC = 0.85) (P = 0.701). US and mammography demonstrated substantial intermodality and interobserver agreement for assessment of breast density.