OBJECTIVES To identify the relationship between human epidermal growth factor receptor 2 (HER2) status and cone-beam breast CT (CBBCT) characteristics in surgically resected breast cancer. METHODS Preoperative CBBCT of patients with BI-RADS 4 or 5 lesions identified on mammography or ultrasound and dense or very dense breast tissue were retrospectively evaluated in 181 surgically resected breast cancer (triple-negative excluded) between May 2012 and November 2014. A set of CBBCT descriptors was semiquantitatively assessed by consensus double reading. Reader reproducibility was analyzed. Multivariable logistic regression analysis using backward elimination (BEA) with the Wald criterion was performed to identify independent predictive factors of harboring HER2/neu. Principle component analysis (PCA) was used to determine characteristics that might differentiate HER2 status. Receiver operating characteristic (ROC) curve analyses were conducted to determine the predictive capability. RESULTS HER2 positive was found in 101 (55.8%) of 181 patients. Inter-observer agreement was high for characteristics' assessment. Based on BEA, pathologic grade, maximum dimension, lobulation, ΔCT, and calcification morphology were confirmed as independent predictive factors of HER2/neu overexpression. PCA showed that calcification- and border-related characteristics were the most important for differentiation. ROC curve analyses showed that CBBCT features (AUC = 0.853) were superior to clinicopathologic features (AUC = 0.613, p < 0.001) and comparable with combination (AUC = 0.856, p = 0.866). CONCLUSIONS CBBCT features could be used to prognosticate HER2 status independently, which are potentially complementary to histopathologic result and helpful in guiding biopsy. KEY POINTS • Dmax, lobulation, ΔCT, and calcification morphology are independent predictors of HER2 status. • CBBCT features are superior to clinicopathologic features in HER2+/- discrimination. • CBBCT features are comparable with combination with clinicopathologic features in HER2+/- discrimination.

中文翻译：

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原发性乳腺癌患者中与HER2 / neu过表达相关的锥束乳腺CT特征。

目的确定人表皮生长因子受体2（HER2）状态与经手术切除的乳腺癌的锥形束CT（CBBCT）特征之间的关系。方法回顾性分析2012年5月至2014年11月间在181例手术切除的乳腺癌（三阴性阴性）中经乳房X线照片或超声检查发现的BI-RADS 4或5病变且乳腺组织致密或非常致密的患者的术前CBBCT。通过共识双读半定量评估CBBCT描述符。读者再现性进行了分析。进行了使用Wald准则的后向消除（BEA）进行多变量logistic回归分析，以鉴定携带HER2 / neu的独立预测因素。主成分分析（PCA）用于确定可能区分HER2状态的特征。进行接收器工作特性（ROC）曲线分析以确定预测能力。结果181例患者中有101例（55.8％）发现HER2阳性。观察员之间的共识对于特征评估非常重要。基于BEA，病理分级，最大尺寸，小叶，ΔCT和钙化形态被确认为HER2 / neu过表达的独立预测因素。PCA显示钙化和边界相关特征是区分最重要的特征。ROC曲线分析显示CBBCT特征（AUC = 0.853）优于临床病理特征（AUC = 0.613，p <0.001），并且可以与组合物相比较（AUC = 0.856，p = 0.866）。结论CBBCT功能可用于独立预测HER2状态，这可能与组织病理学结果互补，有助于指导活检。要点•Dmax，小叶，ΔCT和钙化形态是HER2状态的独立预测因子。•在HER2 +/-鉴别方面，CBBCT特征优于临床病理特征。•CBBCT特征可与HER2 +/-鉴别的临床病理特征相结合。