Citation: Pennick MO, Kalia A, Harris O, Barker D, Jois RHS, Audisio RA. Ultrasound Characteristics of Triple Negative Breast Cancer - A Case Series and Review of the Literature. Austin J Clin Diag Res. 2016; 1(1): 1001. Austin J Clin Diag Res - Volume 1 Issue 1 - 2016 Submit your Manuscript | www.austinpublishinggroup.com Pennick et al. © All rights are reserved Austin Journal of Clinical & Diagnostic Research Open Access Abstract Purpose: Breast cancers are subdivided according to biological sub-types and commonly with reference to their expression (or lack thereof) of specifc receptors - Oestrogen (ER), Progesterone (PR) and Her2-neu (HER2). Their behavior is infuenced by receptor subtype, with triple negative status (TRN) conferring the worst overall prognosis. It is benefcial to recognize the malignant features of breast change, but appropriate treatment cannot be initiated based on Ultrasound (US) scan fndings. The purpose of this study was to evaluate our own series of TRN cancers, their ultrasound characteristics and perform a literature review pertaining to this topic. Results: Our series included sixty patients with TRN breast cancer. We found that shape was not a reliable predictor of TRN status. We found the majority of TRN cancers were of non-parallel lie (83%), had irregular margins (68%), were hypoechoic (70%) and showed posterior enhancement (65%). None of the cases in our series showed surrounding’s tissue change. Micro- calcifcations were absent in 92%. Eleven articles and one book chapter were reviewed after a literature search (total of 582 patients). We found little consensus between authors regarding US characteristics in TRN breast cancer. There was a predilection for irregular shape, abrupt lesion boundary, hypoechoic features and posterior enhancement. Micro-calcifcations were absent in the majority of cases. Conclusions: We found little evidence supporting the claims of previous authors that TRN cancers can be identifed by specifc ultrasound characteristics. Tissue diagnosis cannot be replaced by imaging investigations; for any kind of cancer treatment histology is and will be mandatory. Keywords: Triple Negative; Breast Cancer; Ultrasound; Imaging the statistical analysis of questionable value. In this study, we have reviewed the literature and report our experience with ultrasonic features of TRN tumour type at our institute. Materials and Methods Patients selection A consecutive series of patients who had triple negative breast cancer were identifed from our institutional database in between 2008-2012. Two dedicated breast radiologists analyzed their image characteristics. Any correlation between ultrasonographical features was compared against the fndings highlighted by the published relevant literature. Immunohistochemical analysis Hormonal (Oestrogen & Progesterone) and Her-2 status of the cancers were analyzed on core biopsy using standard available kits and were retested when negative on excision specimen. Ultrasound analysis Te ultrasound scans were performed using Voluson 730 Expert, GE with a high resolution 12 MHz linear probe. Te ultrasound images were then analyzed retrospectively by a single breast radiologist with Abbreviations TRN: Triple Negative; USS: Ultrasound; DCIS: Ductal Carcinoma in Situ; ER: Oestrogen Receptor; PR: Progesterone Receptor; HER2: Human Epidermal Growth Factor 2; FNA: Fine Needle Aspiration Introduction Te management of breast cancer and its prognosis is dependent on numerous biological and molecular variables. Cancers which do not express receptors for Oestrogen (ER), progesterone (PR) or human epidermal growth factor 2 (HER2, previously ERBB2) are termed triple negative (TRN). TRN cancers tend to occur in younger women and confer a worse prognosis than the other breast cancer subtypes. Early identifcation of these TRN subtypes could facilitate aggressive therapy and hence better outcomes. Some recent publications have looked at image characteristics of TRN cancers and the diagnostic accuracy of diferent imaging modalities in predicting triple negative status. Literature reports TRN cancers exhibit certain specifc morphological features, which could assist quicker TRN tumour type diagnosis before the histology reports are available. However, there is a lack of consensus amongst authors regarding which features that are typical of TRN disease. Moreover the studies have tended to be of small sample size, which has made Research Article Ultrasound Characteristics of Triple Negative Breast Cancer - A Case Series and Review of the Literature Pennick MO 1 *, Kalia A 2 , Harris O 3 , Barker D 4 , Jois RHS 1 , Audisio RA 1,5 1 Department of Surgery, St Helens & Knowsley NHS Trust, St Helens Hospital, England 2 Department of Surgery, Southport & Ormskirk NHS Trust, Southport District General Hospital, England 3 Department of Radiology, St Helens & Knowsley NHS Trust, Whiston Hospital, England 4 Department of Pathology, St Helens & Knowlsey NHS Trust, Whiston Hospital, England 5 University of Liverpool, England *Corresponding author: Mandana O Pennick, Department of Surgery, St Helens & Knowsley NHS Trust, St Helens Hospital, England Received: July 20, 2016; Accepted: August 19, 2016; Published: August 23, 2016