Correlative study of sonological appearance of BI-RADS 4 and above breast lumps with histopathology and immunohistochemistry markers

Background: Breast cancer is clinically categorized into 4 major subtypes, ER (+), PR (+), Her2 (+), and TNBC. Although the correlation between sonographic features of breast cancer and immunohistochemistry markers expression is found, it is not still very clear; thus, this study aimed to investigate the ultrasound features of breast cancer and analyze the correlation between them. Methods: This was a prospective study, in which patients with breast lumps were sonologically categorized as BI-RADS 4 and above. Percutaneous biopsy was done. Histopathology and immunohistochemistry markers were correlated with ultrasound findings. Results: ER (+), PR (+) tumors were associated with irregular shape. ER (+), PR (+), and Her2 (+) tumors were associated with indistinct margin. TNBC tumor was associated with microlobulated margin. TNBC cases had more posterior acoustic enhancement. Conclusions: Young female with ultrasound features of oval/round shape, micro-lobulated margin, abrupt tumor interface, showing posterior acoustic enhancement, absence of microcalcification was significantly associated with TNBC.  Tumor with an irregular shape, indistinct margin, hyperechoic halo, no change in posterior acoustic feature, and presence of microcalcification were significantly associated with ER (+) cancers. Tumor with irregular shape, indistinct margin, and no change in the posterior acoustic feature was significantly associated with PR (+) cancers. Tumour with indistinct margin, and hyperechoic halo is significantly associated with Her2 (+) cancers. Tumor with irregular shape, indistinct margin, hyperechoic halo, and no posterior acoustic feature was associated with NTNBC.