Correlation between ultrasonic features and expression of immunohistochemical factors in invasive ductal carcinoma of the breast.

Background: Breast cancer is the most common malignancy among women globally, with invasive ductal carcinoma (IDC) accounting for approximately 80% of all breast cancer cases. IDC exhibits significant heterogeneity in terms of pathological manifestations and prognosis, which are largely influenced by the expression of immunohistochemical (IHC) factors. The study aimed to investigate the correlation between ultrasonic features and the expression of IHC factors in IDC of the breast. Methods: A retrospective analysis was conducted of the clinical data of patients with IDC confirmed by surgery and pathology from January 2019 to December 2022, with ultrasonography performed pre-operation and standard sonograms retained. Specifically, the correlation between sonographic signs and the expression of IHC factors such as estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), E-cadherin, and Ki-67 was investigated using the univariate and binary logistic regression analyses. E-cadherin was included due to its role in epithelial-mesenchymal transition and metastasis in IDC. Key sonographic features (e.g., Adler grade, morphology, posterior echo) and IHC factors were analyzed. Results: The study identified significant associations between specific ultrasonic features and IHC factor expression. For ER expression, irregular shape [odds ratio (OR) =1.694, 95% confidence interval (CI): 1.032-2.309, P=0.011], reduced posterior echo (OR =1.904, 95% CI: 1.211-2.901, P=0.008), and hyperechoic halo (OR =3.705, 95% CI: 1.277-7.903, P=0.003) were associated with ER-positive expression, while Adler grade II-III was associated with ER-negative expression (OR =0.390, 95% CI: 0.127-0.745, P<0.001). For PR expression, hyperechoic halo (OR =4.905, 95% CI: 2.664-11.231, P=0.01) was associated with PR-positive expression, while smooth margin (OR =0.513, 95% CI: 0.132-0.784, P<0.001) and maximum diameter ≥2 cm (OR =0.622, 95% CI: 0.267-0.874, P=0.005) were associated with PR-negative expression. Calcification (OR =1.806, 95% CI: 1.237-4.584, P=0.002) and maximum diameter ≥2 cm (OR =1.409, 95% CI: 1.194-2.385, P=0.01) were associated with HER-2-positive expression. Lymphatic metastasis (OR =1.450, 95% CI: 1.057-2.328, P=0.03) and Adler grade II-III (OR =0.704, 95% CI: 0.406-1.242, P=0.02) were associated with E-cadherin-positive expression. Reduced posterior echo was associated with Ki-67-negative expression (OR =0.307, 95% CI: 0.106-0.684, P=0.02). The areas under the ROC curves for each IHC factor were as follows: ER, 0.832; PR, 0.756; HER-2, 0.675; E-cadherin, 0.684; Ki-67, 0.703. Conclusions: Since IHC factors are correlated with ultrasonic features to some extent, their biological behaviors can be preliminarily identified through analyses of their sonographic features, thereby providing a reference for clinically individualized treatment regimens and prognosis evaluation of patients.