Sonographic Features of Invasive Ductal Breast Carcinomas Predictive of Malignancy Grade.

CONTEXT:Assessment of individual sonographic features provides vital clues about the biological behavior of breast masses and can assist in determining histological grade of malignancy and thereby prognosis.AIMS:Assessment of individual sonographic features of biopsy proven invasive ductal breast carcinomas as predictors of malignancy grade.SETTINGS AND DESIGN:A retrospective analysis of sonographic findings of 103 biopsy proven invasive ductal breast carcinomas.MATERIALS AND METHODS:Tumor characteristics on gray-scale ultrasound and color flow were assessed using American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) Atlas Fifth Edition. The sonographic findings of masses were individually correlated with their histopathologic grades.STATISTICAL ANALYSIS USED:Chi square test, ordinal regression, and Goodman and Kruskal tau test.RESULTS:Breast mass showing reversal/lack of diastolic flow has a high probability of belonging to histological high grade tumor (β 1.566, P 0.0001). The masses with abrupt interface boundary are more likely grade 3 (β 1.524, P 0.001) in comparison to masses with echogenic halos. The suspicious calcifications present in and outside the mass is a finding associated with histologically high grade tumors. The invasive ductal carcinomas (IDCs) with complex solid and cystic echotexture are more likely to be of high histological grade (β 1.146, P 0.04) as compared to masses with hypoechoic echotexture.CONCLUSIONS:Certain ultrasound features are associated with tumor grade on histopathology. If the radiologist is cognizant of these sonographic features, ultrasound can be a potent modality for predicting histopathological grade of IDCs of the breast, especially in settings where advanced tests such as receptor and molecular analyses are limited.