Diagnostic value of Doppler ultrasound in evaluation of breast tumors

Angiogenesis is an essential condition for tumor growth. Therefore, it seems to be of interest to prove if blood flow and vascularization of breast tumors give information concerning their dignity. Consequently, 205 patients with palpable and/or mammographically detected breast tumors were examined prior to surgery by doppler sonography for blood flow in the area of the tumor. In 174 patients of this group the corresponding area of the contralateral breast was also screened by doppler ultrasound. With third doppler generation angiodynography tumors can be visualized as B-images with simultaneous information on vascularization. An integrated doppler system shows the detected blood flow in form of a doppler curve, also allowing quantification according to doppler criteria (Resistance Index RI). Blood flow detection in the tumor itself was successful in 71% of all malignancies, whereas in only 6.6% of the 76 benign lesions (n = 5) blood flow was found in the central tumor area. In the area surrounding the tumor blood flow was detected in 83% of all carcinomas, but only in 29% of benign findings. Blood flow could be detected significantly higher in malignancies than in benign lesions (p = 0.003). Blood flow detection in the tumor itself was a highly specific (93%) method of discrimination between malignant and benign breast tumors. Further quantification by means of doppler parameters only increases insignificantly specificity, quantification of blood flow in the area surrounding the tumor using the RI and the comparison with the contralateral breast could improve the diagnostic value as our findings RI < 8 for benign vs. > or = 8 for malignant lesions demonstrated. Detection of malignant tumors showed a sensitivity of 80%, a specificity of 90%, and a positive predictive value of 93%. In patients with breast cancer (histologically confirmed) the detection rate of blood flow in tumors and surrounding areas was independent of tumor size or nodal status.