title: Evaluation of solid breast lesions with power Doppler: value of penetrating vessels as a predictor of malignancy.
abstract: BACKGROUND
  This study aimed to evaluate the vascular pattern of solid breast lesions using power Doppler ultrasonography (PDUS) and assess whether the presence of intratumoural penetrating vessels can predict breast cancer malignancy.
  
  
  METHODS
  Greyscale ultrasonography (US) and PDUS were prospectively performed on 91 women in Malaysia with histopathologically proven breast lesions. The diagnostic accuracy of greyscale US, PDUS, and both greyscale US and PDUS was calculated and compared.
  
  
  RESULTS
  The 91 women had 102 breast lesions (55 benign, 47 malignant). Of the 47 malignant lesions, 36 demonstrated intratumoural penetrating vessels. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of greyscale US findings in diagnosing malignancy were 100.0%, 71.4%, 74.1% and 100.0%, respectively. The presence of calcification in the breast lesion and the margin, shape and posterior acoustic features of the lesion were significant parameters in predicting malignancy (p < 0.01). The sensitivity, specificity, PPV and NPV of the presence of intratumoural penetrating vessels in predicting malignancy were 76.5%, 80.0%, 76.5% and 80.0%, respectively. When both greyscale US and PDUS were used, there was a significant correlation in predicting malignancy (p < 0.05). The specificity and PPV values of the combined greyscale US and PDUS method (89.0% and 85.7%, respectively) were higher than those of greyscale US or PDUS alone.
  
  
  CONCLUSIONS
  Flow patterns revealed by PDUS can be useful for differentiating benign and malignant breast lesions. The visualisation of penetrating vessels in solid breast lesions can be used to complement greyscale US findings in predicting malignancy.
authors.affiliation: Department of Biomedical Imaging, University Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Rositaa
authors.initials: R
authors.lastname: Ibrahim
authors.affiliation: Department of Biomedical Imaging, University Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Kartini
authors.initials: K
authors.lastname: Rahmat
authors.affiliation: Department of Biomedical Imaging, University Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Farhana
authors.initials: F
authors.lastname: Fadzli
authors.affiliation: Department of Biomedical Imaging, University Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Faizatul Izza
authors.initials: FI
authors.lastname: Rozalli
authors.affiliation: Department of Biomedical Imaging, University Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Caroline Judy
authors.initials: CJ
authors.lastname: Westerhout
authors.affiliation: Department of Biomedical Imaging, University Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Kasumawati
authors.initials: K
authors.lastname: Alli
authors.affiliation: Department of Biomedical Imaging, University Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Anushya
authors.initials: A
authors.lastname: Vijayananthan
authors.affiliation: Department of Biomedical Imaging, University Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Fatimah
authors.initials: F
authors.lastname: Moosa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D001941:Breast Diseases / Q000000981:diagnostic imaging; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008296:Malaysia; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler; D016217:Ultrasonography, Mammary; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: breast cancer; penetrating vessel; power Doppler; ultrasonography