Ultrasonographic features and inflammatory status associated with tumor size in breast invasive ductal carcinoma

This study explored how ultrasound features relate to tumor size and inflammatory markers in invasive ductal carcinoma (IDC) patients.

We retrospectively reviewed 218 female IDC patients. Based on the largest diameter of the tumor, patients were split into two groups: those with tumors ≤ 2 cm and those with tumors > 2 cm. We gathered data from conventional ultrasound (CUS), contrast-enhanced ultrasound (CEUS), and virtual touch tissue imaging quantification (VTIQ), along with blood-based inflammation indicators like neutrophil count and C-reactive protein (CRP) levels. Group comparisons were done using univariate analysis, and Spearman correlation was used to examine relationships between tumor size and other variables.

Larger tumors were more frequently located in the upper outer quadrant (60.71% vs 41.03%, P = 0.035) and showed richer blood flow (73.57% vs 53.85%, P = 0.003). By CEUS, larger tumors were more likely to show high enhancement (90% vs 78.21%, P = 0.017) and expanded enhancement range (82.86% vs 70.51%, P = 0.034). VTIQ results showed that SWV max (P = 0.033), SWV peritumoral average (peri-avg) (P = 0.010), and SWVR max/min (P = 0.009) were significantly increased in the larger tumor group. Correlation analysis showed that tumor size was significantly correlated with the above elastic parameters (P < 0.05). For inflammation, CRP was significantly increased in the larger tumor group (P < 0.001) and positively correlated with tumor size (r = 0.249, P = 0.0002); neutrophils were also correlated with SWV peri-avg (r = 0.158, P = 0.019) (P < 0.05).

Tumor size in IDC patients is not only related to their ultrasonographic features but also reflects their inflammatory status.