BLOOD-FLOW DIAGNOSTICS OF BREAST-TUMORS UNDER INCREASED BLOOD-PRESSURE - NEW POSSIBILITIES IN ESTABLISHING THE NATURE OF THE TUMOR

On the assumption that the architecture of blood vessels of malignant tumors, formed by neoangiogenesis, shows characteristics that are diff erent from those of blood vessels of benign tumors or physiological fi ndings, we have tried in the present study to investigate the behavior of these different vessels under increased blood pressure. Using a sp ecial stand, the same sonographic section could be stably maintained d uring an examination time of approx. 4 minutes. Using a new computer p rogram, the color pixels of the employed Angio color technique were qu antified and recorded as a function of the measured blood pressure. To increase blood pressure, the patient had to press a hand grip, which practically always caused a systolic blood pressure elevation of more than 15-20 mmHg. Seventy patients with sonographically detected breast tumors were examined; 54 (14 benign and 40 malignant tumors) could be included in the evaluation. We found four typical types of curves: Cu rve type 1 is associated with an instantaneous increase in blood flow with increased blood pressure, followed by a drop in the blood pressur e, with a slow decrease in blood flow as the blood pressure drops (wit h 29 malignant and 3 benign tumors). Curve type 2 shows a continuous i ncrease in blood flow - though somewhat delayed with respect to the ri se in blood pressure - which is also observed when the blood pressure drops (exclusively benign tumors). In curve type 3, maximum blood flow is reached after the blood pressure maximum, and then the blood flow decreases (1 benign and 3 malignant tumors). Curve type 4 features dec reased blood flow in spite of increased blood pressure (3 benign and 5 malignant tumors). The described quantification method, in combinatio n with the stand, permits for the first time analysis of a tumor under increased blood pressure as to its blood flow behavior over time in a n examination using a challenge test. Here one can find two distinctiv e curve types (types 1 and 2) that correlate mostly with malignant (ty pe 1) or benign (type 2) breast tumors. Should this tendency be substa ntiated by additional large-scale studies, it would seem that a new ul trasonic possibility for differential diagnosis has been found.