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Dopplerography of breast diseases
Last reviewed: 23.04.2024
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Echography when combined with the Doppler method can detect newly formed tumor vessels. Color Doppler mapping and energy dopplerography are considered as a promising addition to echography for differentiating the breast tissue. With color Doppler mapping around and inside many malignant tumors, a much larger number of vessels can be identified than benign processes. According to Morishima, color doppler mapping from 50 cancers revealed vascularization in 90% of cases, color signals were located peripherally in 33.3% of cases, centrally in 17.8%, chaotically in 48.9%. The ratio between the area of vascularization and the size of education 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 size of the tumor in which the color signals were detected was 1.6 cm, while at a tumor size of 1.1 cm there was no vascular recording at all. In the analysis of 24 cancers of the breast, the number of poles of vascularization was taken into account, which averaged 2.1 for malignant and 1.5 for benign formations.
When attempting a differential diagnosis of benign and malignant processes using pulse dopplerography, the following factors should be considered:
- 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 unvascularized;
- the detection of tumor vessels depends on the technical capabilities of the ultrasound device to record low rates.
The ultrasound method can detect changes in lymph nodes in various pathological processes in the mammary glands, determine their size, shape, structure, and the presence of a hypoechogenic rim. The revealed rounded hypoechoic formations from 5 mm in diameter can be the result of inflammation, reactive hyperplasia, metastasis. The rounded shape, the loss of the hypoechoic rim and the reduction of the echogenicity of the image of the lymph node portal suggest its infiltration by tumor cells.
Ultrasound of the mammary glands has a higher sensitivity in the detection of axillary lymph nodes compared with the data of palpation, clinical evaluation and X-ray mammography. According to Madjar, palpation gives up to 30% of false negative results and the same false positive data on lymph node involvement. Echography revealed 73% of breast cancer metastases in the axillary lymph nodes, while palpation - only 32%.
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