Abstract: Background　By comparatively analyzing breast cancer epidemics at home and abroad，we found that the average timing of breast cancer in China is 5-10 years earlier than that in western countries.And breast cancer in young women is more aggressive，resulting poorer prognosis.At present，there are few reports on imaging studies of breast cancer in young women.Objective　To explore the ultrasonographic features of invasive ductal carcinoma and its molecular subtypes in young women.Methods　Participants were 249 cases of invasive ductal carcinoma recruited from First Hospital of Shanxi Medical University from September 2014 to July 2018，all were female，aged 22 to 75 years old，undergoing preoperative breast ultrasonography，and receiving definite diagnosis by postoperative pathological examination.Ultrasonographic data were collected，including the maximum diameter，shape，aspect ratio，bounder，margin，internal echo，calcification，posterior echo，and blood flow，and were compared between the young group（91 cases，≤35 years old） and middle-aged and elderly group（158 cases，>35 years old）．According to the immunohistochemical determination results of estrogen receptor（ER），progesterone receptor（PR），human epidermal growth factor receptor 2（HER2） and Ki-67，invasive ductal carcinoma in the young group was divided into Luminal A，Luminal B，HER2-enriched，and basal-like molecular subtypes，and the ultrasonographic features of the subtypes were compared.Results　There were significant differences in maximum diameter，internal echo，calcification and posterior echo of the carcinoma between young and middle-aged and elderly groups （P<0.05）．The numbers of Luminal A，Luminal B，HER2-enriched，and basal-like molecular subtypes of invasive ductal carcinoma in young group were 6，53，22，and 10，respectively.These four subtypes showed significant differences in the shape，boundary，internal echo and calcification（P<0.05）．Higher percentages of Luminal B and HER2-enriched subtypes were found with calcification compared with other two subtypes（P<0.05）．Conclusion　Ultrasound images of invasive ductal carcinoma in young women were characterized by large maximal diameter，uneven internal echo，and often accompanied with calcification，and less posterior echo attenuation.And the ultrasound features were related to their molecular subtypes.

Key words: Carcinoma, ductal, breast；Ultrasonography, mammary；Pathology, molecular；Femininity

摘要： 背景　对比中外乳腺癌流行病数据，发现中国的年轻乳腺癌患者平均发病时间比西方国家早5~10年，其乳腺癌侵袭性强，预后差。目前关于年轻乳腺癌患者的影像学研究报道较少。目的　探讨年轻女性乳腺浸润性导管癌及其不同分子亚型的超声声像图特征。方法　收集2014年9月—2018年7月在山西医科大学第一医院接受乳腺超声检查并经术后病理检查确诊的乳腺浸润性导管癌患者249例，均为女性，年龄22~75岁。根据患者年龄分为年轻组（≤35岁）91例，中老年组（>35岁）158例。记录并比较两组超声声像图特征，包括肿块最大径、形态、纵横比、边界、边缘、内部回声、钙化灶、后方回声、血流情况。根据雌激素受体（ER）、孕激素受体（PR）、人类表皮生长因子受体2（HER2）、细胞增殖抗原（Ki-67）免疫组化结果，分为Luminal A型、Luminal B型、HER2过表达型、基底样型，比较年轻组不同分子亚型之间超声声像图特征。结果　两组肿块最大径、内部回声、钙化灶、后方回声情况比较，差异均有统计学意义（P<0.05）。年轻组中Luminal A型6例，Luminal B型53例，HER2过表达型22例，基底样型10例。年轻组乳腺浸润性导管癌不同分子亚型的形态、边界、内部回声、钙化灶情况比较，差异有统计学意义（P<0.05）。Luminal B型、HER2过表达型钙化灶比例高于Luminal A型、基底样型（P<0.05）。结论　年轻女性乳腺浸润性导管癌超声声像图以肿块最大径大、内部回声不均匀、易伴钙化及后方回声衰减少见为特征；且超声声像图特征与其分子亚型存在一定相关性。

关键词: 癌, 导管, 乳腺；超声检查, 乳房；病理学, 分子；年轻