COLOR-CODED AND SPECTRAL DOPPLER FLOW IN BREAST CARCINOMAS - RELATIONSHIP WITH THE TUMOR MICROVASCULATURE

The phenomenon of tumor angiogenesis is an important aspect of underst anding tumor biology. Studies in breast carcinoma have shown microvess el density (MVD) assessed by immunohistochemistry to be of prognostic importance in primary breast cancer. On the other hand, recently devel oped highly sensitive color-coded Doppler techniques offer a noninvasi ve method to examine neovascularisation in breast tumors. The purpose of this study was to determine the relationship between Doppler flow p arameters and microvessel count assessed by immunohistochemistry. Fift y-three patients with primary breast cancer were examined preoperative ly with color-coded Doppler ultrasound. The obtained Doppler frequency spectra were analyzed for peak systolic flow velocity (Vmax). Followi ng surgery, paraffin-embedded microsections were immunohistochemically stained for factor VIII-related antigen, Tumor angiogenesis was asses sed by microvessel count under light microscopy. Undifferentiated tumo rs correlated with high MVD (p = 0.009) whereas other clinicopathologi cal parameters were not associated with MVD. Color Doppler signals wer e detected in 50 out of 53 breast tumors. Evaluation of tumor flow vel ocity with various clinicopathological parameters showed a significant correlation with tumor size (p = 0.0001) and lymph node metastasis (p = 0.02). However, there was no significant correlation between MVD an d intratumoral blood flow velocity assessed by color-coded Doppler. Ou r findings showed that Doppler flow measurement did not correlate with the extent of tumor angiogenesis of breast cancer. The present data g ive circumstantial evidence that microvessel count assessed by immunoh istochemistry reflects the microvascular network, whereas tumor vascul ature documented by Doppler ultrasound supplies information on the mac rovasculature.