Details
Category: Volume 05 Issue 08 August 2017
Hits: 1052

Title: Colour Doppler Study in Differentiating Malignancy and Benign Breast Lumps

Authors: Dr Neethu Thomas, Dr Sajitha, Dr Josey Verghese

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i8.208

Abstract

Background: Colour Doppler sonography and Pulsed Doppler sonography have been used for last several years to evaluate breast tumours. But there are as yet no reliable investigational standards in colour Doppler sonography to classify the lesion as benign or malignant. Another reasonable goal of breast USG suggested is to identify a sub group of masses that have a very low risk of malignancy so that the option of follow-up can be offered as a viable alternative to biopsy. Accurate differentiation between benign and malignant breast nodules could result in improved care and reduction of patient discomfort, morbidity and health care cost.

Aim of this study are to determine whether Doppler and Color flow imaging is reliable in differentiating benign from malignant breast nodules and compare and correlate the ultrasound findings with biopsy results.

Materials and Methods: This is an observational study with diagnostic test evaluation. The study population consisted of 64 women over the age of 30 years, presented with a breast nodule either on clinical examination or with mammography. Doppler sonography was performed on arterial vessels within the lesion. Multiple Doppler samples was taken from all the parts of the tumour, including the margins. Only the highest systolic peak flow velocity was used for statistical analysis. Doppler frequency spectra was analysed for peak systolic velocity (Vmax.), resistance index and pulsatility index. Stastistical analysis was done with SPSS v20 software. Biopsy taken from all lesions and results were compared with Doppler results.

Results: Blood flow parameters RI, PI and peak systolic velocity showed significant difference between benign and malignant. The cutoff values for these parameters were determined by plotting ROC curves. In our study RI and PI showed higher values compared to benign tumors, due to increased impedance in these lesion.

Conclusion: We arrived at cut-off value for RI and PI by drawing ROC curves. RI >0.61 and PI > 0.98 is significant for malignancy.

Keywords: Doppler, Resistivity index (RI), Pulsatality index( PI),Peak systolic velocity (V max).

References

  1. Center for disease control and prevention. Cancer prevention and control. [Online].;2014 [cited 2014 September 2. Available from: http:// www. cdc.gov/ cancer/ dcpc/data/women.htm
  2. Bagchi S. Breast cancer rises in India. CMAJ. 2008 Jul 1 ;179(1):27
  3. Chala LF, de Barros N . Breast evaluation and imaging methods. Radiologia Brasileira. 2007 ;40 (1): 4-7.
  4. Stavros AT . Breast Ultrasound. 1st ed.: Lippincott Williams & Wilkins.; 2004.
  5. Sehgal CM, Arger PH, Rowling SE, Conant EF, Reynolds C, Patton JA. Quantitative vascularity of breast masses by Doppler imaging: regionalvariations and diagnostic implications. J Ultrasound Med. 2000 Jul;19(7):427-40
  6. Lee SK, Lee T, Lee KR, Su YG, Liu TJ. Evaluation of breast tumors with colorDoppler imaging: a comparison with image-directed Doppler ultrasound. J Clin Ultrasound. 1995 Jul-Aug;23(6):367-73
  7. Moon WK, Im JG, Noh DY, Han MC. Nonpalpable breast lesions: evaluation with power Doppler US and a microbubble contrast agent-initial experience. Radiology. 2000 Oct;217(1).-240-6.
  8. Schelling M, Gnirs J, Braun M, Busch R, Maurer S, Kuhn W, Schneider KT, Graeff H. Optimized differential diagnosis of breast lesions by combined B-mode and color Doppler sonography. Ultrasound Obstet Gynecol. 1997 Jul;10(l):48-53
  9. Schelling M, Gnirs J, Braun M, Busch R, Maurer S, Kuhn W, Schneider KT, Graeff H. Optimized differential diagnosis of breast lesions by combined B-mode and color Doppler sonography. Ultrasound Obstet Gynecol. 1997 Jul;10(l):48-53
  10. Peters-Engl C, Medl M, Leodolter S. The use of colour-coded and spectral Doppler ultrasound in the differentiation of benign and malignant breast lesions. Br J Cancer. 1995 Jan;71(l):137-9
  11. Lee SW, Choi HY, Baek SY, Lim SM. Role of color and power doppler imaging in differentiating between malignant and benign solid breast masses. J Clin Ultrasound. 2002 Oct;30(8):459-64

Corresponding Author

Dr Sajitha

Additional Professor, Govt. Medical College, Kottayam, Kerala, India

Phone: 9447596346, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.