Systematic Review and Meta-analysis of the Malignant Ultrasound Features of Triple-Negative Breast Cancer.

Objectives: The malignant ultrasound (US) features of breast cancer are known to include an irregular shape, a noncircumscribed margin, an echogenic halo, a nonparallel orientation, posterior acoustic attenuation, microcalcification, and others. However, these US features are uncertain and controversial for the diagnosis of triple-negative breast cancer (TNBC). This study aimed to analyze the diagnostic value of malignant US features for TNBC by a systematic review and meta-analysis, analyze the US characteristics of TNBC, and provide US evidence for clinical diagnosis.

Methods: A comprehensive search was performed to identify relevant English articles concerning the US diagnosis of TNBC (from the date of database establishment to November 2019). The pooled sensitivity, pooled specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio with 95% confidence interval, summary receiver operating characteristic curve, and area under the curve for the different malignant US features were calculated.

Results: Ten studies (620 patients) met the eligibility criteria. The sensitivity (range, 0.14-0.68) and specificity (range, 0.19-0.66) of the malignant US features were not high. Summary receiver operating characteristic curves showed that the area under the curve (range, 0.25-0.47) of the malignant US features was low, demonstrating that these features have poor diagnostic value for TNBC. The positive likelihood ratio (range, 0.4-to 0.9) of the malignant US features was low, and the negative likelihood ratio (range, 1.09-2.02) was not low, revealing that these features had a poor ability to confirm or exclude TNBC.

Conclusions: Triple-negative breast cancer lacks the typical malignant US features of breast cancer and has its own US features.