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

OBJECTIVES: This study explored how ultrasound features relate to tumor size and inflammatory markers in invasive ductal carcinoma (IDC) patients. METHODS: 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. RESULTS: 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). CONCLUSIONS: Tumor size in IDC patients is not only related to their ultrasonographic features but also reflects their inflammatory status.