The Application Value of Ultrasound Imaging in the Differential Diagnosis of Benign and Malignant Breast Nodules of BI-RADS 3 and Above

Objective:To explore the diagnostic value of ultrasound imaging for breast nodules of breast imaging-reporting and data system(BI-RADS)category 3 and above.Methods:From June 2021 to July 2022,163 patients with breast nodules of BI-RADS 3 or above were selected as the research subjects.After pathological diagnosis,24 cases were malignant breast nodules of BI-RADS 3 or above,while 139 cases were benign breast nodules of BI-RADS 3 or above.The diagnosis rate of malignant and benign breast nodules of BI-RADS 3 or above,including 95%CI,was observed and analyzed.Results:The malignant and benign detection rates of conventional ultrasound were 88.63%and 75.00%,respectively,and the malignant and benign detection rates of ultrasound imaging were 93.18%and 87.50%,respectively,with 95%CIs greater than 0.7.Conclusion:Ultrasound imaging can help improve the diagnostic accuracy of benign and malignant breast nodules of BI-RADS 3 and above and reduce the misdiagnosis rate.

Diagnostic value of artificial intelligence automatic detection systems for breast BI-RADS 4 nodules

BACKGROUND The incidence rate of breast cancer has exceeded that of lung cancer,and it has become the most malignant type of cancer in the world.BI-RADS 4 breast nodules have a wide range of malignant risks and are associated with challenging clinical decision-making.AIM To explore the diagnostic value of artificial intelligence(AI)automatic detection systems for BI-RADS 4 breast nodules and to assess whether conventional ultrasound BI-RADS classification with AI automatic detection systems can reduce the probability of BI-RADS 4 biopsy.METHODS A total of 107 BI-RADS breast nodules confirmed by pathology were selected between June 2019 and July 2020 at Hwa Mei Hospital,University of Chinese Academy of Sciences.These nodules were classified by ultrasound doctors and the AI-SONIC breast system.The diagnostic values of conventional ultrasound,the AI automatic detection system,conventional ultrasound combined with the AI automatic detection system and adjusted BI-RADS classification diagnosis were statistically analyzed.RESULTS Among the 107 breast nodules,61 were benign(57.01%),and 46 were malignant(42.99%).The pathology results were considered the gold standard;furthermore,the sensitivity,specificity,accuracy,Youden index,and positive and negative predictive values were 84.78%,67.21%,74.77%,0.5199,66.10%and 85.42%for conventional ultrasound BI-RADS classification diagnosis,86.96%,75.41%,80.37%,0.6237,72.73%,and 88.46%for automatic AI detection,80.43%,90.16%,85.98%,0.7059,86.05%,and 85.94%for conventional ultrasound BI-RADS classification with automatic AI detection and 93.48%,67.21%,78.50%,0.6069,68.25%,and 93.18%for adjusted BI-RADS classification,respectively.The biopsy rate,cancer detection rate and malignancy risk were 100%,42.99%and 0%and 67.29%,61.11%,and 1.87%before and after BI-RADS adjustment,respectively.CONCLUSION Automatic AI detection has high accuracy in determining benign and malignant BI-RADS 4 breast nodules.Conventional ultrasound BI-RADS classification combined with AI automatic detection can reduce the biopsy rate of BI-RADS 4 breast nodules.

高频彩色多普勒超声联合BI-RADS分级在临床鉴别诊断良恶性乳腺结节中的应用价值

目的:探讨高频彩色多普勒超声联合乳腺成像报告和数据系统(BI-RADS)分级在临床鉴别诊断良恶性乳腺结节中的应用价值。方法:选择2022年1月—2023年6月漳州市第二医院收治的197例乳腺结节患者作为研究对象。所有患者均完成高频彩色多普勒超声检查,以BI-RADS分级标准进行分级,将病理学检查作为金标准,分析高频彩色多普勒超声联合BI-RADS分级对恶性乳腺结节的诊断效能。结果:病理学检查结果显示,在197例乳腺结节患者中,有58例为恶性结节,139例为良性结节;高频彩色多普勒超声联合BI-RADS分级诊断恶性乳腺结节的敏感度为93.10%(54/58),特异度为61.87%(86/139),准确度为71.07%(140/197),阳性预测值为50.47%(54/107),阴性预测值为95.56%(86/90)。恶性乳腺结节血管收缩期最大流速(Vsmax)、血管舒张期最低流速(Vdmin)高于良性乳腺结节,差异有统计学意义(P<0.05);恶性乳腺结节的结节血供丰富、结节内部回声低占比高于良性乳腺结节,结节形态规则、结节边界清晰占比低于良性乳腺结节,差异有统计学意义(P<0.05)。结论:高频彩色多普勒超声联合BI-RADS分级在临床鉴别诊断良恶性乳腺结节中的应用价值较高。

BI-RADS分级联合UE在乳腺癌诊断中的价值分析

目的:探讨乳腺影像报告与数据系统(BI-RADS)分级联合超声弹性成像(UE)在乳腺癌诊断中的价值。方法:选取2019年1月—2022年1月洛阳伊洛医院检查的126例疑似乳腺癌患者作为研究对象,均采用BI-RADS分级及UE技术检查,以手术病理为金标准,判断两种检查方法联合使用的灵敏度、特异度、阳性预测值、阴性预测值、准确性。结果:126例患者中,手术病理结果显示78例患者为乳腺增生,48例为恶性肿瘤。乳腺癌组BI-RADS分级及UE评分较乳腺增生组更高,差异有统计学意义(t=7.641、10.618,P<0.05);联合检查灵敏度、特异度、阳性预测值、阴性预测值、准确性分别为95.83%、98.72%、97.87%、97.47%、97.62%,BI-RADS检查分别为79.17%、89.74%、82.61%、87.50%、85.71%,UE检查分别为77.08%、88.46%、80.43%、86.25%、84.13%,联合检查灵敏度、特异度、阳性预测值、阴性预测值、准确性较BI-RADS分级与UE检查更高,差异有统计学意义(χ^(2)=7.554、6.861、7.474、6.896、14.171,P<0.05)。结论:BI-RADS分级联合UE在乳腺癌的检查中具有较高的诊断价值,可有效提高疾病诊出率及诊断效能。

Correlation of BI-RADS grading with cancer cell proliferation and invasion

Objective:To investigate the correlation of BI-RADS grading with cancer cell proliferation and invasion.Methods: A total of 138 patients who were diagnosed with breast cancer in our hospital between August 2015 and October 2017 were divided into 2 cases at stage Ⅲ, 51 cases at stage Ⅳ and 85 cases at stage Ⅴ after the BI-RADS grading was reviewed. Differences in the expression of proliferation-related genes and invasion-related genes were compared among the three groups of patients.Results: Expressions of pro-proliferation genes MTA2, mTOR, PKM2, Notch1 and FSCN1 mRNA in lesion tissue of patients at stage Ⅴ and Ⅳ were higher than those of patients at stage Ⅲ whereas expressions of anti-proliferation genes BRCA1 and PTEN mRNA were lower than those of patients at stage Ⅲ;expressions of pro-invasion genes Gab2 and NUAK1 mRNA were higher than those of patients at stage Ⅲ whereas expressions of anti-invasion genes EBP50, EDN3, FBXW7 and NDRG1 mRNA were lower than those of patients at stage Ⅲ. With the increase of BI-RADS grades, the expression levels of pro-proliferation genes and pro-invasion genes further increased while the expression levels of anti-proliferation and anti-invasion genes further decreased in the lesion tissue.Conclusions: BI-RADS grading of patients with breast cancer is positively correlated with the proliferation and invasion activity of cancer cells.

Is Breast Background Parenchymal Enhancement on MRI Related to BI-RADS Score and Follow-Up Rate?

Objective: We investigated the correlations between background parenchymal enhancement (BPE) and MRI interpretations with respect to short-interval follow-ups and biopsy rates. Methods: All accessible MRI examinations from 128 women during a limited time period in 2016 were evaluated. A blinded radiologist visually categorized BPE as minimal, mild, moderate, or marked. A BI-RADS category was also assigned. We used descriptive statistics to report the findings and chi-square and Fisher’s exact tests to compare categories. Results: Prevalence of minimal, mild, moderate, and marked BPE was 14.1%, 43.0%, 32.0%, and 10.9%, respectively. The short-interval follow-up rates were 22.2%, 27.3%, 26.8%, and 7.1% in women with minimal, mild, moderate, and marked BPE, respectively. BPE was not associated with the short-interval follow-up rate (p-value = 0.477). Biopsy rates were 22.2%, 27.3%, 22.0%, and 57.1% in women with minimal, mild, moderate, and marked BPE, respectively. Although there was no significant relationship between biopsy rates and BPE levels (p-value = 0.095) in the total population, these two factors were significantly associated in premenopausal women (p-value = 0.023) and in women of 30 - 39 years (p-value = 0.001). Conclusion: Higher BPE does not correlate with short-interval follow-up rates, but appears to be related to biopsy rate, thus causing false-positives and unnecessary biopsy recommendations, particularly in younger, premenopausal women.

超声弹性成像应变率比值对乳腺BI-RADS4级肿块的分级校正价值

目的:分析超声弹性成像应变率比值对乳腺BI-RADS 4级肿块的分级校正价值。方法:收集2014年1月至2016年6月120例承德医学院附属医院乳腺肿块手术切除患者资料,术前全部肿块BI-RADS分级为4级,经超声弹性成像应变率比值校正后重新分级,以病理为金标准分析超声弹性成像应变率比值对BI-RADS分级的校正价值。结果:120例乳腺BI-RADS 4级肿块经超声弹性成像应变率比值校正后,其中46例维持BI-RADS 4级不变、59例降为BI-RADS 3级、15例升为BI-RADS 5级,与病理对照,超声弹性成像应变率比值校正前后的灵敏度、特异性及准确性分别为100%、0%、45%;90.7%、81.8%、85.5%,特异度及准确性校正前后差异有统计学意义(P<0.05),灵敏度校正前后差异无统计学意义(P>0.05)。结论:超声弹性成像应变率比值对BI-RADS 4级肿块分级校正具有一定的临床价值。

BI-RADS分级在彩超检查乳腺良、恶性肿瘤中的规范化应用

目的:通过彩超检查手段,探讨BI-RADS分级在乳腺肿瘤中的规范化应用及其价值。方法:回顾性分析多例经手术、病理证实的乳腺良、恶性肿瘤患者的超声表现及彩色多普勒血流特点,重点是恶性肿瘤及交界性肿瘤的界定,规范其诊断时的应用标准。结果:经手术及活检病理诊断,经过术前BI-RADS分级方法筛查,超声诊断符合率为89.5%,其中误诊为良性54例(6.2%),误诊为恶性36例(4.2%),主要是4级(a,b,c)结节的鉴定存在误诊及偏差。结论:乳腺恶性肿瘤在声像图中的可疑征象:形态不规则、边缘不光整、高回声晕、垂直生长、后方回声衰减、瘤体内微钙化、血供丰富,其中形态不规则、边缘毛刺、边缘成角、肿瘤内微钙化为预测恶性肿瘤的主要指标,其余改变可作为次要指标。通过对上述指标的合理应用,使用统一的专业术语、标准的诊断归类及检查程序,达到早期、准确的诊断乳腺疾病尤其是恶性肿瘤。

超声MicroPure成像技术在BI-RADS 4级乳腺小肿块患者的应用价值研究

目的观察超声MicroPure成像技术对乳腺影像报告和数据系统(BI-RADS)4级乳腺小肿块的临床价值。方法 96例BI-RADS 4级乳腺小肿块患者,按照检查方法不同分为常规组和研究组,每组48例。常规组行常规超声检查,研究组在常规组基础上加用超声MicroPure成像技术检查。以术后病理为标准,比较两组患者乳腺物微钙化检出率,观察两种检查方法对肿瘤的大小、形态、边界及内部回声等影像学情况。结果以术后病理为标准,研究组乳腺物微钙化检出率为100.00%,显著高于常规组的79.17%,差异具有统计学意义(P<0.05)。常规超声检查发现乳腺肿块微钙化以短棒状和斑块状常见,而超声MicroPure成像技术良性肿块微钙化以粗大颗粒状为主,恶性以微小强光点为主,呈簇状排列。结论超声MicroPure成像技术能早期清晰显示BI-RADS 4级乳腺微钙化,有助于早期发现乳腺癌,是临床乳腺癌早期检查较好选择。

乳腺彩超BI-RADS分级在不同年龄患者良恶性肿瘤的诊断研究

目的探讨彩超的BI-RADS分级在不同年龄患者良恶性肿瘤诊断研究。方法选取我院接收的500例乳腺肿瘤患者为研究对象,由超声医师进行检查及操作,分为传统乳腺彩超诊断组和乳腺彩超BI-RADS分级诊断组,传统乳腺彩超诊断组以传统方法对乳腺肿瘤进行定性,由彩超医生凭经验主观诊断。乳腺彩超BI-RADS分级诊断组根据2017年美国放射学会提出的"乳腺影像报告和数据系统"(BI-RADS-US)进行分级,针对不同年龄段患者的乳腺肿瘤的声像图特征执行差别化诊断标准。对两组不同年龄的乳腺肿瘤患者的诊断准确率进行比较。结果经手术病理证实,传统乳腺超声诊断组有14例为恶性肿瘤,乳腺彩超BI-RADS分级诊断组有15例为恶性肿瘤。传统彩超诊断组对乳腺肿瘤患者的诊断符合率(35.9%)显著低于乳腺彩超BI-RADS分级诊断组(80.0%),差异有统计学意义(P<0.05)。不同年龄乳腺肿瘤患者中,乳腺彩超BI-RADS分级诊断组的诊断确诊率高于乳腺彩超BI-RADS分级诊断组,且乳腺病灶BI-RADS分级为5级者均为恶性肿瘤,如为4b-4c级,则需进行进一步的病理检查确诊;3-4a级多数未良性肿瘤。结论对于乳腺肿瘤良恶性的定性,乳腺彩超BI-RADS分级诊断组术前彩超诊断精准率相对较高,有效的为临床提供更为精准的术前诊断,提高诊断水平,以选择更适合的治疗方案。

BI-RADS分级系统诊断在提高乳腺良恶性病变鉴别诊断中的临床价值

目的探讨BI-RADS分级系统在乳腺良恶性病变鉴别诊断中的临床价值。方法从2017年1月初开始筛选患者,截止2018年1月底,共纳入422例乳腺肿瘤患者(共559个乳腺肿块)为研究对象,均采用彩色多普勒超声诊断仪对其进行常规超声检查,并按BI-RADS分级系统对患者进行诊断。对结果进行分析比较。结果 BI-RADS分级0级共3个肿块,均为良性;1级0个;2级22个肿块,均为良性;3级482个肿块中13个恶性;4a级33个肿块中6个恶性,4b级9个肿块中4个恶性,4c级7个肿块中6个恶性;5级3个肿块均为恶性;6级0个;4级系统对乳房肿块良恶性诊断的敏感度、特异度、阳性预测值、阴性预测值均较好;乳腺恶性肿块形态不规则、边界不清晰、内部回声低、周围组织不完整、血供丰富及腋下有淋巴结肿大,与乳腺良性肿块相比差异有统计学意义(P<0.05)。结论 BI-RADS分级系统在乳腺肿瘤诊断中有较好的有应用价值,值得推广。

超声MicroPure成像技术在BI-RADS4级乳腺小肿块中良恶性诊断的临床应用

目的探讨超声MicroPure成像技术在BI-RADS4级乳腺小肿块中良恶性诊断的临床应用价值。方法采用流行病学巢氏病例对照研究方法,选取2015年8月-2016年8月期间我院及南海医院检查的直径≤1cm的乳腺小肿块疑似乳腺癌患者65例进行研究,分别对研究对象行常规超声检查和超声MicroPure成像技术的方法检测乳腺肿物微钙化情况,比较两种检测方法的差别,从而评价超声MicroPure成像术在BI-RADS 4级乳腺小肿块中的评估价值。结果以＂病理结果＂为金标准,超声MicroPure成像技术对乳腺肿物微钙化情况检出率高达100.00%（65/65）,明显高于常规超声检查的78.46%（51/65）,差异有统计学意义（P〈0.05）;且超声MicroPure成像技术在BI-RADS 4级乳腺小肿块恶性病变的诊断中,特异性、敏感性、准确性均明显高于常规超声检查,差异有统计学意义（P〈0.05）。结论超声MicroPure成像技术有助于BI-RADS4级乳腺小肿块中良恶性诊断的鉴别,临床应用价值显著,对其临床诊治及预后有重要的指导意义。

超声诊断BI-RADS Ⅲ～Ⅴ级乳腺肿块的临床价值探讨

目的 探讨彩色多普勒超声诊断BI-RADSⅢ～Ⅴ级乳腺肿块的临床价值.方法 回顾性分析术前应用彩色多普勒超声诊断为BI-RADSⅢ～Ⅴ级的乳腺肿块患者共252例,将超声所见与手术病理结果进行对照分析.结果 252例乳腺肿块病灶中,BI-RADSⅢ级154例,病理学证实良性138例（89.6％）,恶性16例（10.4％）;BI-RADSⅣ级66例,病理学证实良性23例（34.8％）,恶性43例（65.2％）;BI-RADS Ⅴ级31例,病理学证实良性1例（3.2％）,恶性30例（96.8％）.结论 在乳腺彩色多普勒超声检查中,应用BI-RADS分级诊断标准可以对乳腺肿块进行良恶性的风险评估,对乳腺肿块的临床诊治具有重要的指导价值.

超声乳腺BI-RADS分级在乳腺包块鉴别诊断中的价值

目的：探讨超声乳腺BI-RADS分级在乳腺包块鉴别诊断中的价值。方法：收治乳腺包块患者100例，比较BI-RADS3～5级病灶在超声特征上的差异，分析其与病理诊断间的关系。结果：BI_RADS3～5级患者88例。手术后的病理证实：BI-RADS3级20例，BI-RADS4级30例，BI-RADS5级38例。不同分级病变在病灶边缘、回声、边界、血流阻力指数等差异均有统计学意义(P＜0.05)。结论：对乳腺包块患者采用超声乳腺BI_RADS分级诊断比较合适，可以为早期恶性肿瘤的诊断和指导提供有效的借鉴和重要的临床依据。

乳腺高频彩色多普勒超声联合自动乳腺全容积超声成像检查中应用BI-RADS分级诊断标准对乳腺实性病灶良恶性的诊断价值

目的:探讨在乳腺高频彩色多普勒超声联合自动乳腺全容积超声成像技术(ABVS)检查中应用BI-RADS分级诊断标准对乳腺实性病灶良恶性的诊断价值。方法:收治乳腺实性病灶患者102例(189个乳腺),采用乳腺高频彩色多普勒超声联合自动乳腺全容积超声成像检查,并采用BI-RADS分级诊断标准进行评估,分析检查结果。结果:102例189个实性病灶中,BI-RADS 3级153个,组织病理学证实良性150个(98.03%),恶性3个(1.9%);BI-RADS 4级23个,组织病理学证实良性2个(8.69%),恶性21个(91.3%);BI-RADS 5级13个,组织病理学证实良性0,恶性13个(100%)。应用BI-RADS分级标准进行评估,BI-RADS分级:3~5级乳腺病灶在冠状切面、边缘、边界、纵横比、钙化、病灶内血供、血流阻力指数方面的差异均有统计学意义(P<0.05)。结论:乳腺高频彩色多普勒超声联合乳腺自动全容积成像检查中,应用BI-RADS分级诊断标准对乳腺实性病灶良恶性鉴别诊断有重要的临床价值。

BI-RADS分级超声诊断乳腺病变应用价值

目的:分析BI-RADS分级超声诊断乳腺病变的应用价值。方法:选取本院2019年10月—2020年10月共24例乳腺病变患者,均行BI-RADS分级超声诊断,分析其诊断结果与应用价值。结果:BI-RADS分级超声诊断为良性病变16例,恶性病变8例,BI-RADS分级中,2级2例,3级15例,4级3例,5级4例。B I-R A D S分级超声诊断的准确度、敏感度、特异度、阳性预测值、阴性预测值分别为87.50%、77.78%、93.33%、87.50%、87.50%。结论:BI-RADS分级超声在乳腺病变诊断中可发挥一定的应用价值,值得推广。

乳腺浸润性导管癌BI-RADS分级与雌激素受体、孕激素受体及人表皮生长因子受体表达的关系

目的探讨乳腺浸润性导管癌乳腺影像报告和数据系统(BI-RADS)分级与雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体(HER-2)表达的关系。方法回顾性分析宝鸡市人民医院2018—2020年收治的100例乳腺浸润性导管癌患者的临床资料,记录所有患者的超声征象、BI-RADS分级和ER、PR、HER-2阳性率,并比较乳腺浸润性导管癌ER、PR、HER-2阳性、阴性患者的BI-RADS分级情况。结果100例患者的ER、PR、HER-2阳性率分别为63.00%、57.00%、46.00%;有毛刺征患者ER、PR阳性率分别为78.79%、78.79%,明显高于无毛刺征患者的55.22%、46.27%,有微钙化患者的HER-2阳性率为54.55%,明显高于无微钙化患者的29.41%,差异均有统计学意义(P<0.05);血流分级Ⅱ~Ⅲ级患者的ER、PR、HER-2阳性率分别为69.05%、61.90%、51.19%,明显高于血流分级0~Ⅰ级患者的31.25%、31.25%、18.75%,差异均有统计学意义(P<0.05);ER、PR、HER-2阳性患者乳腺浸润性导管癌BI-RADS分级明显高于阴性患者,差异均有统计学意义(P<0.05)。结论乳腺浸润性导管癌ER、PR、HER-2阳性表达患者BI-RADS分级明显更高,临床实践中可以将其联合应用,更有助于鉴别患者疾病情况。

乳腺超声BI-RADS分级与癌细胞增殖、侵袭的相关性研究

目的:探讨乳腺超声BI-RADS分级与癌细胞增殖、侵袭的相关性。方法:收集2015年8月~2017年10月间在本院确诊乳腺癌的患者138例,回顾其BI-RADS分期,并分为Ⅲ期2例、Ⅳ期51例、Ⅴ期85例,对比3组患者病灶组织中增殖相关基因、侵袭相关基因表达量的差异。结果:Ⅴ期、Ⅳ期患者病灶组织中促增殖基因MTA2、mTOR、PKM2、Notch1、FSCN1 mRNA的表达量高于Ⅲ期患者(P<0.05),抗增殖基因BRCA1、PTEN mRNA的表达量低于Ⅲ期患者(P<0.05);促侵袭基因Gab2、NUAK1mRNA的表达量高于Ⅲ期患者(P<0.05),抗侵袭基因EBP50、EDN3、FBXW7、NDRG1mRNA的表达量低于Ⅲ期患者(P<0.05)。随BI-RADS分级增加,病灶组织中促增殖、促侵袭基因表达量进一步增加,抗增殖、抗侵袭基因表达量进一步减少。结论:乳腺癌患者超声BI-RADS分级与癌细胞增殖、活性呈正相关。

不同分级乳腺癌BI-RADS MRI特征与血管生成的对比研究

目的探讨不同病理分级BI-RADS MRI特征评估乳腺浸润性导管癌(IDC)血管生成的可能性和诊断价值。方法采用免疫组化法检测42例IDC的微血管密度(MVD)并行病理WHO分级,基于ACR BI-RADS标准记录病灶MRI特征:肿瘤内部信号(均质、不均质)、形态(肿块型、非肿块型)及边缘(光整、不光整)。对比分析在不同WHO分级时,IDC的MRI特征与MVD表达差异和相关性。结果不同WHO分级时,IDC的MRI内部信号、边缘特征差异有统计学意义(P<0.05),敏感性均较高(91.7%,85.3%),特异性均较低(38.9%,50.0%)。不同WHO分级时,肿瘤形态特征差异无统计意义(P>0.05)。WHOⅢ级时,IDC信号均匀组的MVD明显高于不均匀组,二者呈正相关(r=0.765,P<0.05);WHOⅠ-Ⅱ级时,边缘不光整组的MVD高于边缘光整组,二者正相关(r=0.570,P<0.05);余WHO分级的MRI特征对应的MVD值差异不明显,且无相关性(P>0.05)。结论 IDC部分BI-RADS MRI特征可在不同病理分级时一定程度上衡量肿瘤血管生成,有一定的诊断价值。

Histo-and clinico-pathological analysis of a large series of triple-negative breast cancer in a single center in China:Evidences on necessity of histological subtyping and grading

Objective: To investigate histo-pathological distribution and clinico-pathological significance in a large Chinese triple-negative breast cancer(TNBC) patients serials based on the latest understanding of its clinico-pathological diversity, and to provide more information to clinicians to improve precision of individualized treatment of TNBC.Methods: A retrospective analysis was performed on patients with TNBC at Breast Disease Center, Peking University First Hospital between January 2010 and December 2019. Histo-and clinico-pathological characteristics were analyzed by Chi-square test and Student's t-test, and prognoses were calculated using KaplanMeier method and a Cox proportionate hazards model. Bonferroni correction was used to correct for multiple comparison.Results: Conventional type of TNBC(c TNBC) were identified in 73.7% of 582 TNBC, while special type of TNBC(s TNBC) were 26.3%, including 71 apocrine carcinoma, 20 medullary carcinoma, 31 metaplastic carcinoma, 18 invasive lobular carcinoma, 7 invasive micropapillary carcinoma, 5 adenoid cystic carcinoma and 1 acinic cell carcinoma. Compared to s TNBC, c TNBC was associated with high histologic grade(P<0.001) and lower androgen receptor(AR) expression(P<0.001). TNM stage of low-grade c TNBC was significantly lower than that of high-grade c TNBC(P=0.002). Although no significant difference, there was a trend that the rate of 5-year disease-free survival(DFS) and 5-year overall survival(OS) were longer in high-grade c TNBC than in high-grade s TNBC(P=0.091 and 0.518), and were longer in low-grade s TNBC than in high-grade s TNBC(P=0.051 and0.350). Metaplastic carcinomas showed larger tumor size(P=0.008) and higher proliferative Ki67 index(P=0.004)than c TNBCs.Conclusions: Results from our cohort imply that sub-categorization or subtyping and histological grading could be meaningful in pathological evaluation of TNBC, and need to be clarified in more large collections of TNBC.