BI-RADS category after correction by S-Detect technique in the differential diagnosis of mucinous breast carcinoma
Objective To analyze the clinicopathologic and ultrasonographic features of mucinous breast carcinoma(MBC)and breast fibroadenoma,and to explore the value of BI-RADS category assisted by S-Detect technique to the differential diagnosis of MBC.Methods Totally 54 patients(54 nodules)with MBC(33 cases of pure MBC and 21 cases of mixed MBC)and 47 patients(47 nodules)with breast fibroadenoma were diagnosed by tissue biopsy or postsurgical histopathologic examination in Huangpu Branch of Ninth People's Hospital of Shanghai Jiaotong University School of Medicine from June 2018 to January 2024,and their clinical data were retrospectively analyzed.Routine ultrasonography was done before biopsy or surgery,showing BI-RADS 4 in all 101 patients.S-Detect technique was used to correct BI-RADS category.The sensitivities,specificities and accuracies of ultrasonographic BI-RADS category and corrected BI-RADS category by S-Detect technique in the diagnosis of MBC were compared with the histopathologic examination results.Results(1)The MBC patients were older than fibroadenoma patients[65.50(53.85,70.25)years vs.43.00(34.00,51.00)years](U=6.318,P＜0.001).The tumor diameter was longer in MBC patients[2.20(1.78,2.93)cm]than that in fibroadenoma patients[1.50(1.00,2.00)cm](U=3.871,P＜0.001).Lymph node metastasis occurred in 4 MBC patients,and no lymph node metastasis was found in fibroadenoma patients.(2)The ultrasonographic image of pure MBC mainly showed moderate or mixed echo with regular shape and clear boundary,posterior echo enhancement,no calcification,and Adler blood flow grade 0-Ⅱ.The ultrasonographic image of mixed MBC mainly showed hypoechoicity with irregular shape and unclear boundary,posterior echo enhancement or no change,no calcification,and Adler blood flow grade Ⅱ-Ⅲ.The ultrasonographic image of breast fibroadenoma showed hypoechoicity with regular shape and clear boundary,no change of posterior echo,no calcification,and Adler blood flow grade 0-Ⅱ.(3)The ultrasonographic BI-RADS category was 4a in 58 nodules,4b in 27,and 4c in 16.After correction by S-Detect technique,the BI-RADS category changed from 4a to 3 in 42 nodules,from 4a to 4b in 16,from 4b to 4a in 11,from 4b to 4c in 16,from 4c to 4b in 10,and from 4c to 5 in 6.(4)With the results of histopathologic examination,the sensitivity,specificity and accuracy of ultrasonographic BI-RADS category in diagnosing MBC were 59.26％,76.60％and 67.33％,respectively.The sensitivity,specificity and accuracy of BI-RADS category after correction by S-Detect technique in diagnosing MBC were 77.78％,87.23％and 82.18％,respectively.The sensitivity and accuracy of BI-RADS category after correction by S-Detect technique were higher than those of ultrasonographic BI-RADS category(x2=4.293,P=0.038;x2=5.902,P=0.015),and the specificities of them two were not statistically different(x2=1.795,P=0.180).Conclusions MBC patients have older age and longer tumor diameter compared with fibroadenoma patients.The ultrasonographic features of MBC are not typical,and some of them are similar to breast fibroadenoma.The BI-RADS category after correction by S-Detect technique can improve the efficiency on the differential diagnosis of benign and malignant breast nodules.
mucinous breast carcinomabreast ultrasonographybreast ultrasonographyS-Detect techniqueBI-RADS category
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