The usefulness of Doppler angiography in differential diagnosis of benign and malignant breast lesions.

OBJECTIVE

To estimate the usefulness of Doppler angiography in differential diagnosis of benign and malignant breast tumors.

SETTING

District special hospital, 1997-2000.

PATIENTS: 195 women with breast lesions detected by mammography or palpation in the out-patient clinic; 120 (average age 40 years) had benign lesions, and 75 (average age 54 years), malignant tumors, all confirmed by histopathology. There were 125 healthy controls, both pre- and postmenopausal.

METHODS

Areas of tumor in vivo and healthy breast tissue were scanned using the Doppler angiography option of an Acuson 128XP sonograph, with a 7-MHz transducer. The signals were recorded on videotape and transferred with a QuickCapture frame grabber board for PC analysis by HLImage 97 software (256 gray scale). Signal strength was given per 1 cm2. This result was taken as semi-quantitative perfusion of the tissue section.

RESULTS

In malignant breast lesions perfusion was significantly greater than in benign ones. Furthermore, perfusion of malignant lesions was not dependent on the phase of the menstrual cycle (1st vs. 2nd phase). The maximum sensitivity and specificity were 72% and 72.5%, respectively, based on ROC curves.

CONCLUSIONS

This computerized Doppler angiography system is useful for differentiating between benign and malignant breast lesions in combination with other findings. It would also be useful for surveillance of apparently benign lesions. A limitation is the complicated computer analysis.