Background: To evaluate the palpable breast masses using mammography and sonography independently and in combination and to evaluate the additional advantage of Doppler sonography when used in conjunction with grayscale sonography.

Methods: The study was carried out in the department of Radiodiagnosis, Medical college, Kottayam for a period of 18 months in female patients complaining of breast lump. All patients were evaluated with both es showed Doppler vascularity. mammography and sonography independently and in combination. Histopathology follow up was obtained by FNAC/BIOPSY and the results were correlated with mammographic and sonographic findings.

Results: A total of 150 female patients were included in the study. 68 (45.3%)cases were malignant and 82 (54.7%)were benign. Infiltrating ductal carcinoma accounted for 91.1% of malignant mass. Combined mammography and ultrasonography showed more sensitivity (92.6%) and negative predictive value (92.4%) than either modality alone. Among malignant lesions 66.2% show Doppler vascularity whereas only 25.6% of benign cases showed Doppler vascularity.

Conclusion: Sensitivity of mammography was found to decease with increase in breast density. Combined mammography and ultrasonography play an important role in better characterization of breast masses and thereby avoiding unnecessary biopsies in benign lesions.

Keywords: breast masses, mammography, ultrasonography.

1. World Health Organisation, "Fact Sheet No.297: Cancer", 2006.
2. Zonderland H.M, Coerkamp E.G, Hermans J et al. Diagnosis of breast cancer: contribution of US as an adjunct to mammography. Radiology. 1999; 213(2): 413-22.
3. Rahbarh, Sie AC, Hansen G, Princie J S, et al. Benign versus malignant solidbreast masses: US differentiation Radiology 1999; 213: 889-94
4. Chakrabarti K.L, Bahl P, Sahoo M, Ganguly SK, Oberoi C.MRI of breast masses-comparison with mammography .IJRI 2005;15: 381-7. 50.)
5. Dennis MA, Parker SH, Klaus AJ, Stavros AT, et al. Breast biopsy avoidance: thevalue of normal mammograms and sonograms in the setting of a palpable lump.Radiology 2001; 219:186-191. K6L)
6. Boyd NF, Guo H., Martin LJ, et al. Mammographic density and the risk and detection of breast cancer.Nengl J Med.2007;356:227-36.
7. E. Barlow, CD Lehman, Y. Zheng, R.Ballard - Barbash, B.C. Yakaskas etal. Performance of diagnostic Mammography for women with signs or symptoms of breast.
8. Kolb TM, Lichy J, Newhouse JH. Comparison of the performance of screening mammography, physical examination and breast ultrasound and evaluation offactors that influence them. Radiology 2002; 225(l):165-75.
9. Rahbarh, Sie AC, Hansen G, Princie J S, et al. Benign versus malignant solidbreast masses: US differentiation Radiology 1999; 213: 889-94
10. Stavros AT, Thickman D, Rapp CL, et al Solid breast nodules: use of sonography to distinguish between benign and malignant lesions. Radiology1995; 196(l): 123-34
11. Mebrahtu Ghebrehiwet, Estifanos Paulos,  Tsighe Andeberhan. The role  of combined ultrasonography and mammography in diagnosis of breast cancer in Eritrean women with palpable abnormalities of breast. JEMA
12. Park YM, Kim EK, Lee JH Palpable mass with benign morphology at sonography: Can biopsy be deferred.Acta Radiol.2008; 14: 1
13. Raza et al -Solid breast lesions: Evaluation with power Doppler US. Radiology 1997;203:164-8.
14. Del Cura JL, Elizagaray E, Zabala R, Legorburu A, Grande D. The use ofunenhanced Doppler sonography in the evaluation of solid breast lesions. AJR2005; 184:1788-94..
15. Mesaki K, Hisa N, Kubota K, Ogawa Y, Yoshida S. Differentiating benign and malignant breast tumours using Doppler spectral parameters including acceleration-ntime index. Oncol Rep. 2003; 10: 945-50.

Dr Sajitha K

Department of Radiodiagnosis ,Government Medical College, Kottayam

Mobile No: 9447596346, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.