The Relationship Between Radiological Imaging Features and Pathological Prognostic Parameters and Molecular Subtypes in Breast Cancer

The aim of this study is to evaluate the relationship between mammography and ultrasonography findings and histopathological features and molecular subtypes in patients diagnosed with breast cancer. Materials and Methods: A total of 184 patients diagnosed with breast cancer at Kütahya University of Health Sciences Evliya Çelebi Training and Research Hospital between 2018 and 2023 were included in this retrospective study. Radiological findings and histopathological data of patients who underwent ultrasonography and mammography were retrospectively reviewed. The relationships between imaging characteristics, histopathological parameters, and molecular subtypes were analyzed. Results: On ultrasonography, the most common malignant features were spiculated margins, irregular shape, and hypoechogenicity. Doppler vascularity and microcalcifications were frequently observed. Mammography most commonly demonstrated mass lesions. Invasive ductal carcinoma was the predominant histological type, and most tumors were larger than 2 cm with high Ki-67 levels. Smooth and round–oval mammographic features were significantly more frequent in Triple-negative and HER2-positive tumors, while spiculated margins were more common in Luminal A and Luminal B HER2-positive subtypes. Doppler vascularity and isoechoic echogenicity were more frequent in Triple-negative tumors. Good agreement was observed between imaging and pathology for axillary lymph node and microcalcification detection. Conclusion: Mammography and ultrasonography provide valuable information regarding breast cancer molecular subtypes. Imaging features such as smooth margins, isoechoic echogenicity, and Doppler vascularity may raise suspicion for Triple-negative breast cancer and support early biopsy decisions.