Evaluation of breast tumors with color Doppler imaging: A comparison with image‐directed Doppler ultrasound

Abstract

Doppler ultrasound is an adjunct to other imaging modalities in differentiating benign from malignant breast tumors. Two groups of patients with breast nodules were examined using a 10/4.5 MHz (imaging frequency/pulsed Doppler frequency) image-directed Doppler probe and a 7.0/5.0 MHz color Doppler imaging probe, separately. Whenever flow signals were detected within or at the margin of the breast nodule, the lesion was considered to be malignant. In detecting malignant breast tumors, the sensitivity was 77.3% and 94.5%, specificity 83.3% and 40.1%, accuracy 81% and 63.4% for image directed Doppler and color Doppler imaging, respectively. We found color Doppler to be easier and more efficient in detecting the flow signals of neovascularity in breast tumor. Color Doppler exhibits a higher sensitivity in detecting the malignant breast tumors. However, more false-positive diagnoses were made. Color Doppler ultrasound also expedited the examination, and the whole procedure could be shortened from 35 minutes to 8 minutes compared with our previous examination performed by image-directed Doppler ultrasound. Due to its higher sensitivity and saving in examination time, we use color Doppler imaging as a routine procedure when solid lesions are observed in x-ray mammography or sonography, as a supplement to the diagnosis of breast tumors.

Colour Doppler Study in Differentiating Malignancy and Benign Breast Lumps

“…Coordinates In the present study, 88.4% masses were vascular., which correlates strongly with a study by Lee et al in which an increased vascularity was found in 94% of malignant nodules, with a 60% increase in blood flow in benign nodules 6 . In our study increased blood flow was detected in 86.4% of malignant breast nodules as opposed to in 13.6% of benign lesions.…”

“…Although the malignant masses exhibited a strong gradient in vascularity, core > periphery > surrounding tissue, the benign masses had relatively uniform distribution of vascularity. 5,6 Contrast-enhanced power Doppler US was superior to nonenhanced power Doppler US in the demonstration and characterization of tumor vascularity in nonpalpable breast lesions. 7 The RI and PI values in malignant breast masses shows higher values compared to benign masses, due to increased impedance in these lesions.…”

Imaging of Male Breast Cancer

“…Pulsed Doppler imaging in breast carcinoma is thought to exhibit the following characteristics: PSV, 0.05-0.47 m/s; EDV, 0.07-0.09 m/s; RI, 0.67-0.81; and PI, 1.47-1.76 (Trofi mova 2000a , b ;Fisenko and Sandrikov 1998 ;Madjar et al 1995 ;Youssefzadeh et al 1996 ). According to Lee et al ( 1995 ), PSV in 67 % of breast carcinomas exceeds 0.15 m/s. According to Shevchenko ( 1999 ), the velocities of arterial blood fl ow in malignant tumors are as follows: PSV, 4.6-56.6 cm/s (average value, 18.98 cm/s); EDV, 0.3-9.8 cm/s (average value, 2.99 cm/s); and RI, 0.56-1.34 (average value, 0.82).…”

Evaluation of Doppler Spectral Indices As ‘Tests’ with High Sensitivity for the Provisional Diagnosis of Malignancy in Solid Breast Masses and the Recruitment of Cases for Confirmatory Tests

“…2 However advances in technology and equipment have led to detection of Doppler flow in many solid benign lesions. [3][4][5][6][7][8][9][10][11] Morphology of the vessels with preference to their location at periphery, extension into the centre and their branching pattern has been evaluated as a predictor of malignancy. 5 Doppler spectral indices, namely pulsatility index (PI) and resistive index (RI) have been used to differentiate malignant breast masses from benign ones.…”