The aim of this study is to evaluate the correlation between multidetector row helical computed tomography (MDCT) findings and the histopathological characteristics of patients with invasive ductal carcinoma. We retrospectively reviewed MDCT findings and the corresponding histopathological features of 442 women with invasive ductal carcinoma. We received informed consent from the patients and the protocol was approved by the Ethics Committee at Tohoku University. The median age was 53years (26-89years). We examined the MDCT findings based on mass shape classified into well, moderate, poorly and scattered demarcated shapes, the enhancement pattern classified into homogenous, heterogeneous, rim and poor, and mass density classified into high, intermediate or low. We subsequently compared these radiological findings with the histological characteristics and clinical outcome. Poorly demarcated types were higher in ER+/HER2- (P=0.008), while the well-demarcated type was higher in ER-/HER2- and ER-/HER2+ (P<0.001 and P=0.010). Rim pattern was higher in ER-/HER2- (P<0.001). Intermediate or low density was higher in ER-/HER2- (P<0.001, respectively). Further analysis based on histological grade, mitotic counts and lymphovascular invasion demonstrated that the well-demarcated shape was higher in grade 2 and 3 (P=0.006 and P<0.001, respectively), and rim pattern was observed in grade 3 (P<0.001). Regarding mitotic counts, poorly and scattered demarcated shapes were observed in score 1 (P=0.008 and P=0.014), while well-demarcated shape and rim enhancement were observed in score 3 (P<0.001, respectively). Lymphovascular invasion correlated with a moderate demarcated shape (P=0.029). Regarding recurrence rates, there were statistically significant differences between well and moderate, poorly or scattered demarcated shapes (P=0.007, 0.028 and 0.035, respectively). These proposed MDCT diagnostic criteria based on biological characteristics contribute to more accurately predicting the biological behavior of breast cancer patients.
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