Title: Added Benefit of Doppler Sonography over Mammography and Ultrasonography in the Evaluation of Solid Breast Masses
Authors: Daisy Joseph, Gayathri AR
DOI: https://dx.doi.org/10.18535/jmscr/v7i1.141
Abstract
Background: Breast Cancer is the most common female Cancer worldwide. Imaging of breast plays a crucial role in early detection of carcinoma breast. This study was performed to assess the nature of a solid breast lesion with mammography and gray scale ultrasonography, determine the Color Doppler characteristics of the lesion as well as correlate mammographic, gray scale and Color Doppler Sonographic findings with histopathological reports.
Materials and Methods: A Cross-sectional study was conducted in 50 patients with palpable breast lesionswho underwent mammography, gray scale ultrasonography and Color Doppler in the Department of Radiodiagnosis, Government Medical College, Thrissur. Their data were collected and statistically analyzed.
Results: By combined mammography and sonographic evaluation it was seen that 25 cases had benign morphology and 25 had malignant morphology. 7 out of 25 cases with benign morphology proved to be malignant on histology. Blood Flow was demonstrated in most of the malignant lesions giving a sensitivity of 93.7%, specificity of 66.6% and positive predictive value of 83.3% for determination of malignancy. Number of vessels, high impedance and turbulent flow were found to have predictive value in differentiating benign from malignant lesions.
Conclusion: Being a screening procedure for breast malignancy, mammography alone will not give definitive diagnosis in patients with breast lump. If it is combined with high frequency ultrasound, colour & power Doppler study, accuracy in predicting malignancy increases. Doppler by itself is of little use in evaluation of solid breast lesions. When used in conjunction with conventional examinations it can provide a more accurate characterization of certain lesions. The detection of vessels inside a lesion is significantly linked with neovascularization of malignancy.
Keywords: Breast cancer; mammography; Color Doppler; Neovascularization.