比较三阴性乳腺癌与BI-RADS

目的 观察三阴性乳腺癌（TNBC）与BI-RADS 4A类纤维腺瘤、腺病的超声表现。方法 回顾性分析经病理证实的42例TNBC （TNBC组）、34例超声BI-RADS 4A类的纤维腺瘤（纤维腺瘤组）、36例BI-RADS 4A类的腺病（腺病组）的超声表现，并进行统计学分析。结果 TNBC组与纤维腺瘤组的年龄、病灶大小、形状、内部回声、边缘、BI-RADS分类差异有统计学意义（P均<0.016 7）；TNBC组与腺病组的年龄、肿块大小、边缘、与周边导管关系、BI-RADS分类差异有统计学意义（P均<0.016 7）；纤维腺瘤组与腺病组的形状差异有统计学意义（P<0.016 7）；3组的边界、声晕、后方回声、方位、钙化差异无统计学意义（P均>0.05）。结论 TNBC乳腺癌多见于50岁以上女性，病灶多>2 cm，表现为极低回声，不规则形，边界清晰，质硬，BI-RADS分类多4B及以上；超声BI-RADS 4A类的纤维腺瘤常呈分叶形或不规则形，边界清晰；超声BI-RADS 4A类的腺病常呈不规则形，垂直位生长时易与乳腺癌混淆。

Comparison of ultrasonic manifestations among triple-negative breast cancer and BI-RADS 4A atypical fibroadenoma or adenosis

Objective To compare ultrasonic manifestations of triple-negative breast cancer (TNBC), BI-RADS category 4A atypical fibroadenoma and adenosis. Methods Ultrasonic findings of TNBC group (n=42), BI-RADS 4A atypical fibroadenoma group (n=34) and adenosis group (n=36) were analyzed retrospectively, and statistical analysis was performed. Results There were statistically significant differences of age, tumor size, shape, echo, margin and BI-RADS category between TNBC group and fibroadenoma group (all P<0.016 7). There were statistically significant differences (all P<0.016 7) of age, size, margin, peripheral duct changes, and BI-RADS category between TNBC group and adenosis group. There were statistically significant differences of shape between fibroadenoma group and adenosis group (P<0.016 7). There was no statistically significant difference of boundary, halo, posterior acoustic features, orientation, nor calcification among three groups (all P>0.05). Conclusion TNBC often occurs in women older than 50 years old, and the lesions usually demonstrate larger than 2 cm, very lower echo, and irregular shape with distinct margin. TNBC is usually associated with harder elastography feature, and is classified as more than BI-RADS 4B. Fibroadenoma classified as BI-RADS 4A is most likely to be a mass with lobulated or irregular shape with distinct margin. Adenosis classified as BI-RADS 4A often appears irregular and vertical orientation, which may be confused with breast cancer.