THE CONTRIBUTION OF COLOR DOPPLER ULTRASONOGRAPHY FOR THE DIAGNOSIS OF BREAST MASSES:

For the early diagnosis of breast cancer the selection of the proper radiological imaging modality is very crucial. Color Doppler ultrasonography(CDUS) is a non- invasive and easily applicable modality which can detect tumor neovascularization. We aimed to explore the contribution of CDUS to the other modalities for the diagnosis of breast lesions. MATERIAL AND METHOD 71 patients having solid breast masses were evaluated by ultrasonography (US), CDUS, and mammography. Also, spectral datas were examined and maximum peak systolic velocities, minimum end diastolic velocities, resistivity index(RI) values were measured and the presence of venous flows were noted. For the control values same measurements were obtained from locations other than the mass area. Histopathological diagnosis was achieved by fine needle, incisional or excisional biopsies. 49 masses were found to be malignant, 22 masses were benign. FINDINGS Eight of the benign lesions had venous flow pattern, others had arterial vascularity. 2 of the lesions with arterial flow pattern had central, 12 had peripheral vascularization. All had RI values less than 0.70. 2 of the 49 malignant masses had venous vascularization. 22 of the 47 masses with arterial flow had central vascularity. 8 of the malignant masses had RI values below 0.70, 39 malignant lesions had RI values greater than 0.70. Venous vascularization was found to be statistically significant, as a critera for benignity (p<0.05). Also, a statistically significant correlation was found between histopathological diagnosis and central-peripheral vascularity patterns (p<0.05). In addition, higher RI values were found to be a significant criteria for malignancy (p<0.05). CONCLUSION When the modalities US, CDUS, and mammography are used together, the sensitivity for the diagnosis of breast masses was 98%, the specificity was 86%. Positive predictive value was 94% and correction rate was 94%. It was concluded that CDUS is a complementary modality for the differentiation of malignant and benign breast masses.