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Dopplerography of breast diseases
Last reviewed: 04.07.2025
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Echography combined with the Doppler method can detect newly formed tumor vessels. Color Doppler mapping and power Dopplerography are considered as a promising addition to echography for differentiation of breast tissue. Color Doppler mapping around and inside many malignant tumors makes it possible to detect a much larger number of vessels compared to benign processes. According to Morishima, vascularization was detected in 90% of 50 cancers using color Doppler mapping, color signals were located on the periphery in 33.3% of cases, centrally in 17.8%, and chaotically in 48.9%. The ratio between the vascularization area and the size of the formation was less than 10% in 44.4% of cases, less than 30% in 40% of cases, and more than 30% in 11.6% of cases. The average tumor size in which color signals were detected was 1.6 cm, while no vessels were detected at tumor sizes of 1.1 cm. In the analysis of 24 breast cancers, the number of vascularization poles was taken into account, which averaged 2.1 for malignant tumors and 1.5 for benign tumors.
When attempting to differentiate between benign and malignant processes using pulsed Doppler ultrasound, the following factors must be taken into account:
- large proliferating fibroadenomas in young women are well vascularized in 40% of cases;
- small cancers, as well as some specific types of cancers of any size (such as mucoid carcinoma) may be nonvascularized;
- The detection of tumor vessels depends on the technical capabilities of the ultrasound machine to record low speeds.
The ultrasound method can detect changes in the lymph nodes in various pathological processes in the mammary glands, determine their size, shape, structure, and the presence of a hypoechoic rim. The detected round hypoechoic formations of 5 mm in diameter can be the result of inflammation, reactive hyperplasia, and metastasis. The round shape, loss of the hypoechoic rim, and decreased echogenicity of the lymph node gate image suggest its infiltration by tumor cells.
Breast ultrasound has a higher sensitivity in detecting axillary lymph nodes compared to palpation, clinical assessment, and X-ray mammography. According to Madjar, palpation yields up to 30% false negative results and the same number of false positives for lymph node involvement. Echography detected 73% of breast cancer metastases to the axillary lymph nodes, while palpation detected only 32%.
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