SCREENING FOR OVARIAN-CANCER IN WOMEN WITH BREAST-CANCER WITH TRANSVAGINAL SONOGRAPHY AND COLOR-FLOW IMAGING

The aim of the present study was to determine the efficacy of transvag inal color flow imaging as a screening tool for ovarian cancer. Six hu ndred patients with previous breast carcinoma were screened for ovaria n cancer. Screening was performed using transvaginal sonography with c olor flow imaging. Serum CA 125 levels were measured in patients with abnormal sonographic findings. Eighty-three percent of the ovaries wer e detected in the premenopausal patients by ultrasonographic scanning and only 26% of the ovaries were detected in the postmenopausal patien ts. Intraovarian blood vessels were detected in 11% of the premenopaus al women. The PI was less than 1 in 80% of these ovaries, but, on repe ated examinations, the values of PI increased in all the blood vessels to greater than 1. Intraovarian blood vessels were detected in 1.8% o f the normal ovaries observed in the postmenopausal women, but PI was always greater than 1. Eleven women with complex ovarian cysts (not si mple) and one woman with enlarged ovaries underwent explorative laparo tomy. In three women, primary malignant ovarian tumors were diagnosed and in one woman metastatic ovarian cancer was diagnosed. The specific ity of sonography in detecting malignant ovarian tumors was 97.5% and the positive predictive value was 25%. The specificity of color flow i maging in detecting primary malignant ovarian tumors was 99.8% and the positive predictive value was 60%. In selected groups of women, scree ning for ovarian cancer with transvaginal color flow imaging may be ju stified.