Blood flow on ultrasound imaging is a predictor of lump margin status in breast-conserving patients: a retrospective matching study

PURPOSE: This study investigated the relationship between breast ultrasound features and lump margin status in breast-conserving patients. METHODS: A single-institution database and medical records system were searched to identify patients who had undergone breast-conserving surgery between 2015 and 2022. Patients were divided into case and control groups based on their postoperative margin status, and different matching methods [case–control matching (CCM) and propensity score matching (PSM)] were used to match the cases and controls at a ratio of 1:1. RESULTS: Before matching, patients with positive margins were more likely to have a tumor with increased blood flow (OR = 2.90, 95% CI 1.83–4.61, p < 0.001) and microcalcifications (OR = 2.22, 95% CI 1.44–3.42, p < 0.001). Among the 83 pairs of CCM subjects, patients with positive margins were prone to increased blood flow (p = 0.007) and crab sign (p = 0.040). In addition, there was a significant difference in blood flow (p = 0.030) among PSM subjects. After adjusting for the unbalanced factors, the same results were obtained. CONCLUSIONS: Ultrasound blood flow significantly predicts the status of breast-conserving margins, but further studies are required to verify our findings.