Triple-Negative Breast Cancer: Differential Imaging Features Based on Menopausal Status and Race.

Objective: To determine whether menopausal status and race affect the imaging features of triple-negative breast cancer (TNBC).

Methods: This institutional review board-approved retrospective study reviewed the clinicopathologic data and imaging features of patients diagnosed with invasive ductal TNBC from January 1, 2014, to March 30, 2023. There were 199 patients, of whom 67 (33.7%) were pre- and perimenopausal and 132 (66.3%) were postmenopausal. Data analysis was performed using Chi-squared or Fisher's exact test, and a P-value <.05 was considered significant. Subgroup analysis of Black and White patients was also performed.

Results: Sixty-six percent (44/67) of the TNBCs in the premenopausal group were a round- or oval-shaped mass, while an irregular-shaped mass made up 50.5% (65/129) in the postmenopausal group (P = .041). Three (2.3%) TNBCs were out of the mammographic field of view. Forty-two percent (28/67) of the TNBCs in the premenopausal group had indistinct margins, whereas 51.2% (66/129) of the postmenopausal group had spiculated margins (P = .011). Associated calcifications were present in 29.5% (20/67) of the TNBCs in the premenopausal group vs 24.8% (32/129) (P = .395). In subgroup analysis, a round/oval-shaped TNBC was more common in both premenopausal and postmenopausal Black patients-76.9% (20/26) and 54.5% (24/45), respectively (P = .061). However, 57.1% (44/79) of TNBCs in postmenopausal White women were irregular, and 61.0% (47/79) had spiculated margins (P <.009).

Conclusion: Menopausal status and race should be considered in the imaging features of TNBC. These data may further assist in the understanding of the biology of TNBC and lesion characteristics by race.