Correlation of sonographic features of invasive ductal mammary carcinoma with age, tumor grade, and hormone-receptor status

Purpose. To determine whether presenting sonographic features of invasive ductal carcinomas (IDC) are associated with patient age, tumor histologic grade, and hormonal receptor status. Methods. Sonographic features of 101 consecutive cases of IDC seen at ultrasound were retrospectively assessed based on the BI-RADS criteria of posterior acoustic appearance, tumor margins, and echogenicity. Associations between sonographic features and tumor characteristics were statistically evaluated with attention to patient age. Results. IDC with shadowing compared with unchanged posterior acoustic appearance were significantly more likely to be of low histologic grade (Odds Ratio [OR] = 5.00; p < 0.05) and estrogen receptor (ER) -positive (OR = 10.00; p < 0.05). Conversely, posterior enhancement was associated with ER-negative status (OR = 4.45; p < 0.01), particularly among patients younger than 60 years of age (OR = 5.36, p < 0.05). Circumscribed tumors were more often high grade, particularly among older women (p < 0.01), and hormone receptor--negative regardless of age group. Among older women, tumors with mixed echogenicity tended to be high grade and progesterone receptor--negative (p values < 0.05). Noncircumscribed borders were observed for all tumors with posterior shadowing, and 97% of such tumors were also ER positive. Conclusions. Sonographic features were significantly associated with tumor grade and hormone receptor status, with some differences based on patient age. Specifically, the presence of posterior shadowing was associated with lower histologic grade and ER-positive status, especially in older patients. In contrast, we found that posterior acoustic enhancement was more commonly associated with ER-negative status, especially in younger patients. (C) 2012 Wiley Periodicals, Inc. J Clin Ultrasound 2013; Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/jcu.21990