IS THE SONOGRAPHIC DEGREE OF BLOOD-SUPPLY A NEW PROGNOSTIC FACTOR

The aim of the present study was to investigate the relationship betwe en the biological behaviour of breast cancer and ultrasonographically detected blood flow. The investigations were carried out with a protot ype colour ultrasound unit - CSA Acoustic Imaging, Phoenix, MEM colour technique. This machine identifies very low blood flow velocities tha t are not detected by conventional Doppler methodology. Blood flow was assessed on the visual colour information obtained (class I low, bloo d flow, single colour pixels - class III, high blood flow, several col our areas). Although the subjectivity of this classification is a disa dvantage there was no intra-observer variation in this study. In 119 p atients with invasive ductal breast carcinomas, there was a close corr elation between the degree of blood flow and tumour size, lymph node s tatus, S-fraction, ploidy and receptor status. Approximately 91% of pa tients with class I blood flow had negative lymph nodes whereas 81% of women with class III blood flow had lymph node metastases. Low flow w as associated with diploid tumour cells, an S-fraction < 5.0 and posit ive hormone receptor status. Aneuploid tumour cells, high S-fraction a nd negative hormone receptor status correlated strongly with high bloo d flow. This correlation between established prognostic factors and ul trasonographic assessment of blood flow indicates that blood flow in a tumour may have prognostic value and further studies are indicated.