Sonographic Phenotypes of Molecular Subtypes of Invasive Ductal Cancer in Automated 3-D Breast Ultrasound

Jan C.M. van Zelst, Maschenka Balkenhol, Tao Tan, Matthieu Rutten, Mechli Imhof-Tas, Peter Bult, Nico Karssemeijer, Ritse M. Mann

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


Our aim was to investigate whether Breast Imaging Reporting and Data System—Ultrasound (BI-RADS-US) lexicon descriptors can be used as imaging biomarkers to differentiate molecular subtypes (MS) of invasive ductal carcinoma (IDC) in automated breast ultrasound (ABUS). We included 125 IDCs diagnosed between 2010 and 2014 and imaged with ABUS at two institutes retrospectively. IDCs were classified as luminal A or B, HER2 enriched or triple negative based on reports of histopathologic analysis of surgical specimens. Two breast radiologists characterized all IDCs using the BI-RADS-US lexicon and specific ABUS features. Univariate and multivariate analyses were performed. A multinomial logistic regression model was built to predict the MSs from the imaging characteristics. BI-RADS-US descriptor margins and the retraction phenomenon are significantly associated with MSs (both p < 0.001) in both univariate and multivariate analysis. Posterior acoustic features and spiculation pattern severity were only significantly associated in univariate analysis (p < 0.001). Luminal A IDCs tend to have more prominent retraction patterns than luminal B IDCs. HER2-enriched and triple-negative IDCs present significantly less retraction than the luminal subtypes. The mean accuracy of MS prediction was 0.406. Overall, several BI-RADS-US descriptors and the coronal retraction phenomenon and spiculation pattern are associated with MSs, but prediction of MSs on ABUS is limited.

Original languageEnglish
Pages (from-to)1820-1828
Number of pages9
JournalUltrasound in Medicine and Biology
Issue number9
Publication statusPublished - Sept 2017
Externally publishedYes


  • Breast neoplasms
  • Cancer
  • Diagnosis
  • Imaging
  • Ultrasonography
  • molecular subtypes


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