To analyze the clinical and pathological features of breast cancer patients with low classification breast masses diagnosed by color Doppler ultrasound after minimally invasive rotational excision resection.

A retrospective analysis was performed in 22 922 female patients with low breast tumors classified by color Doppler ultrasound before operation in Zhongshan City People's Hospital from March 2008 to December 2021, among whom 284 patients were diagnosed as breast cancer by minimally invasive surgery. The relationship between color Doppler ultrasound classification and age, tumor size, pathological tissue type and molecular subtype was analyzed. Receiver operating characteristic (ROC) curve was drawn to analyze the sensitivity and specificity.

Among the 284 patients, there were 11 cases of BI-RADS 2, 137 cases of BI-RADS 3 and 136 cases of BI-RADS 4a before operation. Histologically, there were; 198 cases of invasive ductal carcinoma, of whom 68 cases were accompanied by partial carcinoma in situ; 19 cases of invasive lobular carcinoma, including 6 cases with partial carcinoma in situ; 29 cases of carcinoma in situ; 12 cases of mucinous carcinoma; 26 cases of other types of cancer. The molecular subtypes were Luminal A type in 96 cases, Luminal B type in 142 cases, triple negative breast cancer type in 37 cases and HER-2 overexpression type in 9 cases. ROC curve showed that the sensitivity of color Doppler ultrasound underestimating before operation was 47.9%, the specificity was 78.1%, and area under curve was 61.8%.

Breast patients with smaller tumors, carcinoma in situ or mucinous carcinoma and triple negative breast cancer are easily underestimated by color Doppler ultrasound before operation, which should be taken into account.