Differential diagnosis of breast lesions by color Doppler

Abstract

Color Doppler allows flow detection in small tumor vessels. Due to the vascularity associated with the growth of malignancies, this method can be used to differentiate between benign and malignant breast lesions. In order to study the typical flow characteristics, we investigated multiple Doppler flow parameters. A UM9 HDI (ATL) was used with a linear transducer L 10-5. The number of tumor vessels and the mean, maximum and total flow velocity were measured in 325 benign and 133 malignant lesions and showed highly significant differences (p < 0.0001). Flow profiles (resistance index and systolic/diastolic frequency ratio) showed a large overlap and did not allow accurate tumor differentiation when mean and minimum values were analyzed. Surprisingly, the maximum resistance index and systolic/diastolic frequency ratio were significantly higher in carcinomas than in benign lesions, but the overlap of the values was wider than the flow velocity measurements. Using the vessel number and the total tumor vascularity, 90% of all lesions could be differentiated. A difficulty that we encountered was that a few cancers have very low flow values and some of the proliferative benign lesions can have increased flow.

Imaging of Male Breast Cancer

“…4.10 ). Madjar et al ( 1995 ) suggested counting all vessels detected within the nodule for quantitative assessment of the vascularity of breast lesions. According to their data, benign lesions demonstrated 2 arteries on the average, whereas malignant lesions demonstrated up to 11 arteries.…”

“…Sohn et al ( 1997 ) consider that the mentioned methods of scoring are too labor intensive and are not reliable in practice because of high operator and scanner dependency. According to Madjar et al ( 1995 ), the vessels in a malignant breast neoplasm can be detected in 43-100 % of instances with 5-14 arteries (8-11 arteries on average) identifi ed within the tumor. Madjar et al ( 1995 ) report that the presence of two and more vessels within a tumor is a typical sign of cancer.…”

“…According to Madjar et al ( 1995 ), the vessels in a malignant breast neoplasm can be detected in 43-100 % of instances with 5-14 arteries (8-11 arteries on average) identifi ed within the tumor. Madjar et al ( 1995 ) report that the presence of two and more vessels within a tumor is a typical sign of cancer. According to Ivanova ( 2006 ), only infi ltrative cancer is vascularized in 100 % of cases.…”

“…They often have irregular calibers (narrow and wide parts) and looped or spiral shapes (Madjar et al 1995 ). Dilation of vessels within breast carcinomas can result from several factors, such as local increase in the temperature and the infl uence of an oxide of nitrogen caused by the malignant process.…”

“…According to Kharchenko et al ( 1993a , b ), PSV in the vessels of healthy breast tissue is 0.06 ± 0.02 m/s, whereas the average PSV within cancer is 0.3 m/s. 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.…”