Colour Doppler ultrasound in the diagnosis of a solid breast mass (original) (raw)
Related papers
Color Doppler Evaluation of Breast Masses
Journal of Evolution of medical and Dental Sciences, 2014
OBJECTIVES: Characterization of solid masses and assignment of levels of suspicion for being malignant on color and spectral Doppler and to co-relate the findings with histopathological features. MATERIAL AND METHODS: Sixty four patients with breast masses were evaluated with duplex and color Doppler ultrasound. Presence or absence of color flow, number of vessels, their situation and spectral Doppler analysis were performed. Comparison of color Doppler analysis with histopathological findings was done. RESULTS: Color signals were more commonly found in malignant (88%) than benign lesions (38%). Malignant lesions showed more number of vessels as compared to benign. Both central and peripheral vascularity was noted in 14 out of 16 malignant masses and in none of the benign masses. Spectral Doppler analysis did not prove to be helpful in differentiating benign from malignant lesions. CONCLUSION: Color Doppler is helpful in assigning a higher level of suspicion to a lesion for being ma...
EVALUATION OF SOLID BREAST LESIONS BY COLOUR DOPPLER ULTRASOUND
In 1991, Judah Folkman emphasized the 'angiogenic switch' hypothesis for tumor progression. Studies have showed that angiogenesis positively correlates with the degree of metastasis, tumor recurrence and shorter survival rates, thereby demonstrating the value of angiogenesis as a prognostic cancer marker. Tumor angiogenesis is similar to physiological angiogenesis; however, latter proceeds in an uncontrolled and excessive manner giving rise to leaky and tortuous vessels that are in a constant state of inflammation. As the malignant breast mass grows, tumor cells secrete peptide growth factors, which promote angiogenesis. Angiogenesis, in turn, provides the tumor mass with nutrients essential to sustain growth. In theory, the altered hemodynamics that accompany tumor angiogenesis provide the basis for discriminating between malignant and benign masses of the breast by color Doppler sonography. Lack of smooth muscle in the arteriolar wall and absence of a normal capillary bed results in modified end-organ resistance and arteriovenous shunting. Tumor angiogenesis plays an important role in the growth and extension of malignant neoplasms, including those of the breast. The increase of tumor mass and the formation of metastasis require the formation of new vessels. Malignant tumors secrete angiogenic factors to help the recruitment on new vessels that allow tumoral enlargement. Therefore, it seems reasonable that a technique that allows vascularization assessment, such as Doppler sonography, could be used to differentiate between benign and malignant breast lesions and even to predict the prognosis of the tumors. Until now, various parameters of Doppler sonography have been analyzed to determine their usefulness in the diagnosis of breast lesions. The detection of vascularization in the lesion was the first Doppler feature used to differentiate between benign and malignant tumors, and this sign has shown a significant association with malignancy of lesions. New vessels that originated as the result of tumor angiogenesis have characteristics that differ from those of normal vessels. These vessels are characterized by their lack of muscle layer, atypical branching pattern, and irregularity, and they frequently present stenosis, occlusions, or arteriovenous fistulas. These vascular anomalies produce alterations in the dynamics of the arterial flow that can be evaluated by means of pulsed Doppler sonography. The RI and PI values for malignant and benign lesions overlap significantly, which makes these values show little usefulness as a tool to differentiate between both types of lesions. The disappearance or reversal of vascular flow in the diastole, which indicates the presence of very high resistance flow, appears to be closely connected to malignancy. This disappearance or reversal of vascular flow can be explained as an extreme case of the previously described phenomena of vascular occlusion, encasement, and stenosis, typical of malignant vascularity causing a great increase in the peripheral resistance of the vascular bed of some of these tumors. The detection of vessels in a tumor has been connected with the involvement of axillary lymph nodes and with lymphatic vascular invasion.
British journal of cancer, 1995
The aim of this study was to evaluate the role of colour-coded and spectral Doppler sonography to predict the benign or malignant nature of breast lesions. A total of 112 women with mammographically suspicious breast lesions were investigated prior to surgery. Thirty-nine breast carcinomas and 73 benign lesions were evaluated for the resistance index, pulsatility index and the flow velocity. A resistance index of > or = 0.70 was characteristic of malignant tumours with a sensitivity of 82% and a specificity of 81%. The positive predictive value was 70% and the negative predictive value 89%. Doppler sonography offers one possible method for further investigation of patients with mammographic abnormalities.
Journal of Clinical Ultrasound, 1995
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 short...
Scholars Journal of Applied Medical Sciences, 2016
The complexity of breast structure, greater breast volume and the extreme sensitivity to endocrine influences are factors that predispose this organ to a number of pathological conditions. Imaging plays an important role in characterization of palpable breast lump. High Resolution Ultrasound acts as an adjunct to physical and mammographic examination to differentiate benign from malignant so as to avoid unnecessary biopsy and surgical excision. Color Doppler imaging helps to identify presence of vascularity in breast lesions and help in characterizing the lesion. Objectives-1. To evaluate different palpable breast lumps on the basis of their color Doppler characteristic, 2. To corroborate the color Doppler diagnosis with histopathological and/or cytological correlation. Material And Methods-Subjects were the patients from indoor ward and outpatient department of Surgery and Gynecology Department. After obtaining consent from the appropriately selected patients, according to the inclusion and exclusion criteria, they were examined using HX color Doppler machine of Hewlett Packard (HP). Different predetermined gray scale and color Doppler parameters were recorded and analyzed according to appropriate statistical methods. Conclusion-Use of color Doppler showed promising results in differentiating the nature of solid breast lumps thereby reducing unnecessary biopsies, allay anxiety and control cost. Flow velocimetry criteria especially RI is most important in characterizing breast masses.
Purpose. This study analyzed the color and power Doppler signals in solid breast masses and assessed their value in differentiating malignant from benign lesions. Methods. One hundred twenty-nine biopsy-proven solid breast masses (54 malignant and 75 benign) were evaluated with color and/or power Doppler so-nography using a 7-MHz linear-array transducer. We retrospectively analyzed the location, shape, and penetration of the Doppler vascular signals in the breast masses. The location of the vascular signals was categorized as central, peripheral, or both. The shape of the signals was categorized as linear, irregular, branching, or a single dot. A penetrating vessel was defined as a continuous vascular signal extending from outside the lesion to inside it. In 43 cases, power and color Doppler sonograms were compared. Results. Doppler features suggestive of malignant lesions were the presence of both peripheral and central vascularity (odds ratio, 6.0), presence of penetrating vessels (odds ratio, 5.4), and presence of branching vessels (odds ratio, 13.7). Power Doppler sonography was more sensitive than color Doppler sonography in detecting vascular signals in 49% of cases. Conclusions. Color (power) Doppler imaging is a valuable adjunct to conventional sonography in differentiating between malignant and benign breast lesions.
Color Doppler Of Breast In Diagnosis Of Breast Carcinoma: Comparative Study With Mammography And Usg
Breast cancer is the second most common cause of death from cancer in women. The aim of this study was to determine which is more accurate imaging test among mammography ,ultrasound and color doppler ultrasound for diagnosis of breast cancer based on the women's age and breast density. We examined 81 patients with breast symptoms, by clinical breast examination which is cofirmed by mammography ,ultrasound and color doppler. A total of 81 breast lesions were compared with final histopathology of the lesion taking it as the gold standard. Sensitivity varied significantly with age and breast density. Adding color Doppler with ultrasound provides a better diagnostic accuracy.
Color Doppler sonography: characterizing breast lesions
Imaging in Medicine, 2010
This article discusses the utilization of Doppler sonography in the breast. The article encompasses the use of Doppler sonography to differentiate benign from malignant lesions to assess neovascularity in tumors to assess the response after chemotherapy and to differentiate benign from malignant lymph nodes based on various blood-flow patterns. The discussion also incorporates the recent advances in the current literature regarding the value of techniques such as sonoelastography, 3D Doppler imaging and the use of tissue harmonics. While mammography remains the prime modality to evaluate breast lesions, advances in the field of ultrasound demonstrate promising results and future hope for a more specific role of ultrasound in this cause. Keywords: 3d doppler n breast ultrasound n doppler sonography n duplex ultrasound n power doppler
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 2000
Seventy-four biopsy proven breast masses were imaged by color and power Doppler imaging to evaluate vascular pattern of malignant and benign breast masses. The images were analyzed for vascularity. The measurements were made over the entire mass as well as regionally at its core, at its periphery, and in the tissue surrounding it. The surgical specimens were analyzed for microvessel density. The diagnostic performance of Doppler sonographic vascularity indices was evaluated by receiver operating characteristic analysis. The malignant masses were 14 to 54% more vascular than the benign masses. Both types of masses were more vascular by ultrasonography than the tissue surrounding them. Whereas benign masses were 2.2 times more vascular than the surrounding tissue, the malignant masses were 5.0 times more vascular. In a subset of patients the regional vascularity at the core, periphery, and surrounding tissue by Doppler imaging exhibited a strong correlation (R2 > 0.9) with the corr...
Clinics, 2014
OBJECTIVES: Despite evidence suggesting that Doppler ultrasonography can help to differentiate between benign and malignant breast lesions, it is rarely applied in clinical practice. The aim of this study was to determine whether certain vascular features of breast masses observed by duplex Doppler and color Doppler ultrasonography (before and/or after microbubble contrast injection) add information to the gray-scale analysis and support the Breast Imaging-Reporting and Data System (BI-RADS) classification. METHODS: Seventy solid lesions were prospectively evaluated with gray-scale ultrasonography, color Doppler ultrasonography, and contrast-enhanced ultrasonography. The morphological analysis and lesion vascularity were correlated with the histological results. RESULTS: Percutaneous core biopsies revealed that 25/70 (17.5%) lesions were malignant, while 45 were benign. Hypervascular lesions with tortuous and central vessels, a resistive index (RI)$0.73 before contrast injection, and an RI$0.75 after contrast injection were significantly predictive of malignancy (p,0.001). CONCLUSION: The combination of gray-scale ultrasonography data with unenhanced or enhanced duplex Doppler and color Doppler US data can provide diagnostically useful information. These techniques can be easily implemented because Doppler devices are already present in most health centers.