THE POSITIVE VOCAL FREMITUS IN MALIGNANT BREAST-TUMOR IN SONOGRAPHIC COLOR MEM-IMAGING - AN EXCITING ARTIFACT FOR CONFIRMING THE DIAGNOSIS

In the experimental phase of application of a new Non-Doppler technolo gy (MEM system, Acoustic Imaging, Phoenix; Dornier Medizintechnik) we observed, that in patients, who spoke during colour imaging of a breas t tumour, artifacts appeared in or around the lesion: the colour artif acts were seen regularly inside the tumour in cases of malignancies, a nd exactly surrounding benign tumours. Postoperative histological find ings served as an objective criterion of classification/differentiatio n. To examine this phenomenon, we performed a study in 71 patients. Th ese women with a sonographically detectable tumour (37 malignant, 34 b enign) were examined on the day before surgery. We observed, that if p atients uttered the number ''99'' with a relatively low voice or alter natively hummed a deep sound, the artifacts could be regularly visuali zed. In 66/71 patients (93%) status evaluation by artifact generation due to vocal fremitus examination was correct. In 3 patients the tumou r was erroneously described as malignant, histology showing a prolifer ative mastopathy. In 2 cases the tumour was classified as benign, wher eas histology revealed a malignancy, in both patients a large ductal-i nvasive carcinoma (greater-than-or-equal-to 3 cm). This phenomena coul d, however, not be reproduced with other colour techniques. A possible explanation is: Thoracic vibrations during speech can be registered b y the MEM technique. These vibrations are not perpetuated into the ben ign lesion characterised by a displacing growth, due to which the vibr ations are ''barred off'' at the borders of the tumour. Infiltrating g rowth typical of a malignancy causes transmission of these vibrations into the center of the tumour. Should this procedure prove efficient i n a larger group of patients, it would be a simple and extremely effic ient method of status diagnosis.