Evaluation of different aspects of power Doppler sonography in differentiating and prognostication of breast masses

Abstract

Background: We conducted our study on 1110 patients with breast masses in order to investigate different aspects of power Doppler sonography (PDS) for differentiating between benign and malignant breast lesions and their prognostication.Materials and Methods: This study was conducted on the women who were referred to the sonography units of University Hospitals for breast sonography and had a BIRADS-3 mass or higher in gray scale sonography. Then, PDS was performed for all the patients.Vascularization, number of vessels, resistance index (RI), pulsatility index (PI), and vascularization patterns were evaluated for all the lesions. We compared our radiologic findings concerning different histopathologic and hormonal aspects of the lesions.Results: The differences between mean vascular density in malignant lesions concerning size of the tumor, histological grade,stage, and hormone receptor status were statistically significant. Although, there was an overlap between benign and malignant values. A resistive index (RI) value higher than 0.83 as a sign for malignancy had sensitivity equal to 75% and specificity equal to 97% (P = 0.04 and 0.03, respectively). A PI value higher than 1.6 has a sensitivity and specificity value of 70% and 98%, respectively,as a malignancy sign (P = 0.02 and 0.04, respectively). Conclusion: It seems that while malignant tumors have significantly higher number of vessels in comparison to benign one, since the number of vessels overlap between benign and malignant tumors, this aspect has little clinical usefulness in distinguishing or prognostication of breast masses. In contrast RI, PI, and vascularization pattern have an ability to differentiate and predict the prognosis of breast lesions.

Key words: Breast cancer, Doppler sonography, vascular density, vascularization