Prognostic roles of ultrasound-based BI-RADS classification in Her2+breast cancer patients

The aim of the current study was to explore the prognostic significance of ultrasound-based Breast Imaging-Reporting and Data System (BI-RADS) classification in patients with human epidermal growth factor receptor-2 positive (Her2+) breast cancer. A total of 344 Her2+ breast cancer patients, treated from April 2005 to January 2016, were recruited. Overall survival (OS) and disease-free survival (DFS) were evaluated using Kaplan-Meier curves. The prognostic value of BI-RADS classification was evaluated using Cox's proportional risk model, along with univariate and multivariate analyses. Results showed that the 344 Her2+ breast cancer patients consisted of 190 BI-RADS 5 patients, 152 BI-RADS 4 patients, and 2 BI-RADS 3 patients. OS and DFS scores of patients with BI-RADS 3-4 were better than those with BI-RADS 5 (P < 0.001, P = 0.005), according to Kaplan-Meier survival analysis. Univariate analysis yielded a negative correlation between BI-RADS classification and OS in Her2+ breast cancer patients (Hazard Ratio (HR): 2.146, 95% Confidence interval (CI): 1.481-3.111, P < 0.001) and between BI-RADS classification and DFS (HR: 1.591, 95% CI: 1.147-2.208, P = 0.005). Multivariate analysis, in contrast, established ultrasonic BI-RADS classification as an independent predictor of OS and DFS in Her2+ breast cancer patients (P < 0.05). In conclusion, increased classification of ultrasound-based BI-RADS classification levels is a risk factor for poor survival in patients with Her2+ breast cancer.