Last update:
29-Sep-2020

Breast cancer is by far the most frequent cancer among women worldwide. The range in mortality rates between world regions is less than the range of the incidence of the disease, because of the more favorable survival of breast cancer in the high-incidence developed regions. This can be explained by the early diagnosis of the disease and timely administration of appropriate chemotherapy adapted to tumor-specific pathological characteristics. In the last decades, important advances have been made in breast cancer pathological classification, which for a long time had been based on the histological characteristics, namely the tumor size, its histological type and grade, and the axillary lymph nodes status. With the introduction of immunohistochemistry, new prognostic factors, indicative of the tumor's aggressiveness, can also be identified, namely estrogen and progesterone receptors, human epidermal growth factor receptor 2 (HER2), and expression of Ki-67 and p53 core proteins. Taking these factors into account, chemotherapy has become even better adapted to the special tumor characteristics, maximizing its effectiveness and minimizing its side effects. In addition, the introduction of contrast media in ultrasound (US) imaging has increased the information provided, making it possible to demonstrate the tumor microcirculation and thus to map angiogenesis. Contrast-enhanced (US) in breast cancer had been used to differentiate between benign and malignant lesions, before the surgery, but in the last decade new studies have evaluated the possible correlation between qualitative and quantitative characteristics of contrast-enhanced US and pathological prognostic factors in breast cancer, which could render US an important, non-invasive diagnostic tool in the selection of the ideal specialized protocol, before surgery.

Key words: Breast cancer, Contrast-enhanced ultrasound, Molecular analysis, Prognostic factors.