Dr. Bushra Arshad, Dr. Mahjabeen Mahmood Kamal, Dr. Muhammad Wasim Awan, Dr. Shaghaf Iqbal, Dr. Syed Naveed Ali Shah, Dr. Wajiha Arshad, Dr. Nasreen Rehmatullah




To determine the diagnostic accuracy of spectral doppler ultrasound in predicting malignancy in evaluation of solid breast lesions taking histopathology as gold standard. Materials and methods: This cross Sectional Validation Study was conducted at Radiology Department, KRL Hospital, Islamabad for six months from1st August 2021 to 31st January 2022. A total of 145 women with solid breast lesions of BI-RADS category scale III-V were included in the study. All women underwent spectral doppler ultrasound of breast and malignancy was considered positive if spectral doppler US image shows resistive index (RI)= 0.68. These patients were then subjected to histopathology. The data was collected on a predesigned proforma and results were analyzed by using the SPSS software version 17.0 by descriptive and inferential statistics.



            In this study age range was 18 to 60 years with mean age of 42.965±7.66 years. Spectral doppler ultrasound has shown sensitivity of 84.8%, specificity 95% and diagnostic accuracy by 92%, PPV 88.6% and NPV 93% in diagnosis of malignant breast lesion.


In conclusion, Doppler examination has a significant role in the evaluation of solid breast lesions for distinguishing malignant tumors from benign lesions.


Solid breast lesions, Spectral doppler ultrasound, Histopathology, Diagnostic accuracy


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Runowicz CD, Leach CR, Henry NL, Henry KS, Mackey HT, Cowens-Alvarado RL, et al. American cancer society/American society of clinical oncology breast cancer survivorship care guideline. Cancer J Clin. 2016;66(1):43-73.

Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. Cancer J Clin. 2019;69(1):7-34.

Berry DA, Cronin KA, Plevritis SK, Fryback DG, Clarke L, Zelen M, et al. Effect of screening and adjuvant therapy on mortality from breast cancer. N Engl J Med. 2015;353:1784-92.

Gokalp G, Topal U, Kizilkaya E. Power Doppler sonography: Anything to add to BI-RADS US in solid breast masses? Eur J Radiol. 2019;70:77-85.

Del Cura JL, Elizagaray E, Zabala R, Legórburu A, Grande D. The use of unenhanced Doppler sonography in the evaluation of solid breast lesions. AJR Am J Roentgenol. 2015;184:1788-94.

Kwak JY, Kim EK, Kim MJ, Choi SH, Son E, Oh KK. Power Doppler sonography: Evaluation of solid breast lesions and correlation with lymph node metastasis. Clin Imaging. 2018;32:167-71.

Cho N, Jang M, Lyou CY, Park JS, Choi HY, Moon WK. Distinguishing benign from malignant masses at breast US: Combined US elastography and color doppler US — influence on radiologist accuracy. Radiology 2012;262:80-90.

Stuhrmann M, Aronius R, Schietzel M. Tumor vascularity of breast lesions: Potentials and limits of contrast-enhanced Doppler sonography. AJR Am J Roentgenol. 2015;175:1585-9.

Folkman J. Tumor angiogenesis: therapeutic implications. N Engl J Med. 2015; 285:1182-6.

Milz P, Lienemann A, Kessler M, Reiser M. Evaluation of breast lesions bypower Doppler sonography. EurRadiol. 2001;11:547-54.

Ibrahim R, Rahmat K, Fadzli F, Rozalli FI, Westerhout CJ, Alli K, Vijayananthan A, Moosa F. Evaluation of solid breast lesions with power Doppler: value of penetrating vessels as a predictor of malignancy. Singapore Med J. 2016;57(11):634-9.

Sirous M, Sirous R, Nejad FK, Rabeie E, Mansouri M. Evaluation of different aspects of power Doppler sonography in differentiating and prognostication of breast masses. J Res Med Sci. 2015;20(2):133-7.

Keshavarz E, Zare-Mehrjardi M, Karimi MA, Valian N, Kalantari M, et al. Diagnostic value of spectral doppler ultrasound in detecting breast malignancies: an original article. Int J Cancer Manag. 2018;11(2):e8200.

BergWA, Blume JD, Cormack JB, Mendelson EB, Lehrer D, Bohm-Velez M, et al. Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer. JAMA. 2008;299(18):2151–63. doi: 10.1001/jama.299.18.2151. [PubMed: 18477782].

89. Sickles EA. Imaging techniques other than mammography for the detection and diagnosis of breast cancer. Recent Results Cancer Res. 1990;119:127–35. [PubMed: 2236853].

90. ChaoTC, Lo YF,ChenSC,ChenMF. Color Doppler ultrasound in benign and malignant breast tumors. Breast Cancer Res Treat. 1999;57(2):193–9. [PubMed: 10598046].

91. Svensson WE, Pandian AJ, Hashimoto H. The use of breast ultrasound color Doppler vascular pattern morphology improves diagnostic sensitivity with minimal change in specificity. Ultraschall Med. 2010;31(5):466–74. doi: 10.1055/s-0028-1109478. [PubMed: 20094978].

. Lee WJ, Chu JS, Houng SJ, Chung MF, Wang SM, Chen KM. Breast cancer angiogenesis: a quantitative morphologic and Doppler imaging study. Ann Surg Oncol. 1995;2(3):246–51. [PubMed: 7543800].

93. Kumar A, Srivastava V, Singh S, Shukla RC. Color Doppler ultrasonography for treatment response prediction and evaluation in breast cancer. Future Oncol. 2010;6(8):1265–78. doi: 10.2217/fon.10.93. [PubMed: 20799873].

94. Campi R, Carlotto M, Gorreta L, Tragni C, Belli L, Tufarulo L, et al. [The role of color Doppler echography in the diagnosis of breast tumors]. Radiol Med. 1990;79(3):182–4. [PubMed: 2186439].

95. Grischke EM, von Fournier D, Sohn C, Wallwiener D, Bastert G. [Diagnostic value of Doppler ultrasound in evaluation of breast tumors]. Zentralbl Gynakol. 1996;118(10):553–9. [PubMed: 8999709].

96. McNicholas MM, Mercer PM, Miller JC, McDermott EW, O’Higgins NJ, MacErlean DP. Color Doppler sonography in the evaluation of palpable breast masses. AJR Am J Roentgenol. 1993;161(4):765–71. doi: 10.2214/ajr.161.4.8372754. [PubMed: 8372754].

97. del Cura JL, Elizagaray E, Zabala R, Legorburu A, Grande D. The use of unenhanced Doppler sonography in the evaluation of solid breast lesions. AJR Am J Roentgenol. 2005;184(6):1788–94. doi: 10.2214/ajr.184.6.01841788. [PubMed: 15908531].

Cosgrove DO, Kedar RP, Bamber JC, al-Murrani B, Davey JB, Fisher C, et al. Breast diseases: color Doppler US in differential diagnosis. Radiology. 1993;189(1):99–104. doi: 10.1148/radiology.189.1.8372225. [PubMed: 8372225].

99. Cosgrove DO, Bamber JC, Davey JB, McKinna JA, Sinnett HD. Color Doppler signals from breast tumors. Work in progress. Radiology. 1990;176(1):175–80. doi: 10.1148/radiology.176.1.2191364. [PubMed: 2191364].

Busilacchi P, Draghi F, Preda L, Ferranti C. Has color Doppler a role in the evaluation of mammary lesions?. J Ultrasound. 2012;15(2):93–8. doi: 10.1016/j.jus.2012.02.007. [PubMed: 23396684].

101. Stanzani D, Chala LF, Barros N, Cerri GG, Chammas MC. Can Doppler or contrast-enhanced ultrasound analysis add diagnostically important information about the nature of breast lesions?. Clinics (Sao Paulo). 2014;69(2):87–92. doi: 10.6061/clinics/2014(02)03. [PubMed: 24519198].


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