Imaging features are tied to pathological findings in breast cancer among young women, a study published January 26 in Clinical Imaging found.
Researchers led by Sepideh Sefidbakht, MD, from the Mohammad Rasool Allah Research Tower in Shiraz, Iran found that round and oval masses on mammography are more common in triple-negative and Luminal B cancers. Additionally, hypoechoic mass and posterior shadowing are the most common findings in breast ultrasound upon diagnosis.
“Given the rising incidence and geographical/ethnic variability of breast cancer in young women, physician awareness is crucial for timely diagnoses and addressing the significant impact of this disease,” Sefidbakht and co-authors wrote.
Previous studies indicate that women are being diagnosed with breast cancer at a younger age. Screening mammography is not typically recommended for women younger than 40 years of age. Furthermore, younger women have denser breast tissue, which limits the performance of mammography. Previous research has also explored potential ties between certain imaging features and the biological features of breast tumors.
Sefidbakht and colleagues analyzed trends in characteristics, molecular subtypes, and imaging findings of breast cancer in women ages 30 and younger. In its retrospective study, the team reviewed a database consisting of 342 cases of primary breast cancer collected between 2001 and 2020. From there, it recorded the following: nuclear subtype and grade, tumor stage, presence of in situ cancer, imaging data including lesion type on mammography and ultrasonography, and treatment data.
On breast ultrasound, hyperechoic mass and posterior shadowing presented the most commonly at 70.9% and 79.2%, respectively, upon diagnosis. Furthermore, posterior shadowing was most common in Luminal cancers, while posterior enhancement was most common in triple-negative cancers (p = 0.03), the team found.
On mammography, 18% of triple-negative cancers and 11.1% of Luminal B cancers had round or oval masses. In contrast, these mass shapes were present in just 2.8% of Luminal A (2.8%) and HER2 cancers (5.3%, p = 0.02).
Also on mammography, microcalcifications were most commonly tied to Luminal B (35.5%) and HER2+ (47.3%) cancers. However, the researchers noted that this difference was not statistically significant (p = 0.31).
Additionally, 23.1% of women with HER2+ breast cancer had no findings on ultrasound.
“This clears the importance of performing mammography in young women with palpable lumps and normal ultrasonography,” the team wrote.
Finally, the researchers reported that microcalcifications were significantly more common in Luminal cancers than HER2 and triple-negative cancers (p = 0.041) and that only 26% of total tumors were 2 cm or less at the time of diagnosis.
The study authors highlighted that knowing the relative proportion of molecular subtypes of breast cancers, clinical presentations, and imaging findings could make way for more timely diagnosis as well as more informed decision-making by clinicians and radiologists.
The study can be found in its entirety here.
