Estrogen receptor-negative invasive breast cancer: Imaging features of tumors with and without human epidermal growth factor receptor type 2 overexpression

Purpose: To prospectively determine if estrogen receptor (ER)-negative human epidermal growth factor receptor type 2 (HER2) positive and ER-negative HER2-negative breast cancers have distinguishing clinical and imaging features with use of retrospectively identified patients and tissue samples. Materials and Methods: This HIPAA-compliant study was institutional review board approved. Informed consent was obtained from living patients and waived for deceased- patients. Mean patient; age at: diagnosis was 53 years (range, 31-84 years). Clinical history; histopathologic, mammographic., and, breast; sonographic findings; and HER2 status as determined with immunohistochemistry or fluorescent in situ hybridization were evaluated in 56 women with ER-negative breast cancer. Imaging appearances and clinicopatho logic characteristics were correlated with tumor HER2 status P < .05 indicated a significant difference. Results: Lesion margins on mammograms (P =.028) and sonograms (P = .023), calcifications on mammograms (P = .003), and clinical cancer stage at diagnosis (P = :029) were significantly associated with HER2 status. In contrast to ER- negative HER2-negative tumors, ER-negative HE positive tumors were more likely to have spiculated margins (56% vs 15%), be associated with calcifications (65% vs 21%), and be detected at a higher cancer stage (74% vs 57%). Conclusion: Biologic diversity of cancers may manifest in imaging characteristics, and, conversely, studying the range of imaging features of cancers may help refine current molecular phenotypes. (C) RSNA 2008.