THE USE OF COLOR-CODED SONOGRAPHY IN EVAL UATING SUSPICIOUS BREAST MASSES

Aim The relationship between tumour vessel density and tumour vitality in breast carcinoma has been well established in histopathological st udies. Our objective was to find out if colour-coded sonography is hel pful in the evaluation of suspicious breast masses. Method 106 patient s were studied; in all cases a biopsy was obtained. Peripheral and cen tral blood vessels in a lesion were counted and peak systolic velociti es (PSV) were measured as well as the resistive index (RI). The grade of vascularisation was scored on a scale from I-IV indicating an incre asing vessel count and increasing PSV. Results 83% of the carcinoma (n =61) and 45% of the benign lesions (n=45) showed vascularity grade III or IV (hypervascularity). The mean PSV of all carcinomas was 0.23 mis , in benign lesions 0.14 m/s (p < 0.005). Although G3 carcinomas showe d higher vascularisation than G2 carcinomas, the difference was not st atisticaly significant. T3 + 4 tumours had significantly higher PSV th an T1 + 2 carcinomas (p < 0.01). In 12 of 23 cases with unclear morpho logy in the B-mode, the additional finding of hypervascularity led to the misinterpretation of a benign lesion as a carcinoma. Conclusion Al though increased vascularity correlated with degree of malignancy the finding of hypervascularity did not help to distinguish a benign from a malignant lesion in individual cases. Consequently, it did not help to reduce the biopsy rate. In benign lesions with hypervascularity and borderline morphology, the risk of a false positive diagnosis is high .