Evaluation of breast lesions by power Doppler sonography.

The aim of this study was to determine the value of power Doppler sonography in the detection of tumor vascularity in breast lesions and to find new diagnostic criteria for differential diagnosis. Power Doppler sonography was prospectively performed in 102 patients with 118 histologic (n = 116) and cytologic (n = 2) results. A semisubjective scoring system for the intratumoral increase in blood flow compared with the flow in normal breast parenchyma (reference structure) was introduced and the flow pattern registered. The difference in the flow increase for benign and malignant breast disease was highly significant (p < or = 0.0001). This applied especially to invasive cancer above a maximum tumor diameter of 5 mm excluding cancer stage Tis and T1a. A positive correlation between cancer size and flow increase were found. The flow pattern was an additional feature. The sensitivity was calculated to be between 74.5 and 78.8%, and the specificity between 74.6 and 77.8%. The level of flow increase in Power Doppler sonography is an important feature in the differential diagnosis of breast lesions and should be considered together with the established criteria in B-mode ultrasound. The flow pattern might also add some important information.