Power Doppler sonography of breast cancer: Does vascularity correlate withnode status or lymphatic vascular invasion?

OBJECTIVE. The purpose of our study was to determine how breast cancer vasc ularity, as revealed by power Doppler sonography, correlates with lymph nod e involvement and lymphatic vascular invasion, MATERIALS AND METHODS. Breast sonograms obtained during a 2-year period wer e retrospectively reviewed. Patients who underwent power Doppler sonography of solid masses and had biopsy-proven carcinoma composed our study populat ion. Power Doppler findings were categorized according to the presence or a bsence of vessels. Pathologic findings were reviewed for lymph node involve ment and lymphatic vascular invasion. RESULTS. Of 176 patients with breast cancer, vessels were seen on power Dop pler sonography in 128 (73%) and not seen in 48 (27%). Of 126 patients who underwent lymph node dissection, vessels were seen in 97 (77%) and not seen in 29 (23%). Lymph node involvement was seen in 42 (43%) Of the 97 patient s in whom vessels were seen and in three (10%) of the 29 in whom vessels we re not seen. Of 150 patients examined for lymphatic vascular invasion, vess els were seen in 111 (74%) and not seen in 39 (26%). Lymphatic vascular inv asion was seen in 47 (42%) of the 111 patients in whom vessels were seen an d in five (13%) of the 39 in whom vessels were not seen. CONCLUSION. Tumor vascularity revealed by power Doppler sonography correlat ed strongly with detection of lymph node involvement and lymphatic vascular invasion, with sensitivities of 93% and 90%, respectively. However, the sp ecificities were low, at 32% and 35%, respectively. More important, patient s with breast cancer in whom vessels were not revealed by power Doppler son ography also were unlikely to have lymph node involvement and lymphatic vas cular invasion: Negative predictive values were 90% and 87%, respectively.