Role of spectral doppler in evaluation of palpable breast masses in co-relation with ultrasound guided FNAC

Jeevika MU, Mahesh BG, Harikiran Reddy, Yashas Ullas L, Mounisha Kethineni

Abstract


Background: Breast disease is one of the most common complaints of females belonging to any age group. The breast masses range from benign to malignant. Breast carcinoma is the second most common cause of mortality in females. Therefore, early diagnosis is important for better management. The aim of this study is to assess the value of flow velocity and RI, in evaluating solid breast masses, to compare it with pathology results, and to determine specific gray scale characteristics with Doppler parameters of lesion with FNAC correlation in differentiating benign from malignant lesions.
Materials and Methods: This prospective study was conducted at Department of Radio-Diagnosis, Bapuji Hospital & Chigatere General Hospital, Davangere attached to Jaya Jagadhguru Murugarajendra Medical College, Davangere. Total number of subjects selected for the study was 50 patients of age ranging between 17-56 years. Initially sonography was performed and data was obtained. Then tissue diagnosis was obtained in all 50 cases and and final diagnosis was obtained. Patients who are referred to ultrasound with palpable
breast masses were included in this study. The detailed physical and clinical examination was done for all the study subjects, in addition to sonography and histopathological examination. In this study all US examinations were performed with a 6-13 MHz high frequency linear-array transducer of volusen E6 model. FNAC/Surgical Biopsy of these ultrasonographically detected breast lesions were done. FNAC of breast lesions were done under ultrasound guidance. FNAC was avoided in those patients with prolonged BT, CT, PT and decreased platelets counts. After correction of these abnormalities, patients were subjected
to FNAC.
Results: In the present study, spectral doppler shows sensitivity of 92% and specificity of 96% in diagnosing breast lesions when compared with FNAC. In the present study, benign tumor was seen in 26 cases and malignant tumor was observed in 24 cases. Compared with benign, malignant tumor showed  significantly increased RI, PI and Vmax. USG diangosis of Palpable Breast Masses showed that, carcinoma was seen in 23 (46%), Fibroadenoma 14 (28%), Abscess and Phyllodes Tumour in 5 (10%) cases each and Galactocoele in 1 (2%) case. In the current study, FNAC diagnosis of palpable breast masses showed that, Fibroadenoma in 16 (32%) cases, IDC in 13 (26%) cases, IDC with Metastatic Lymphadenopathy and Carcinoma in 5 (10%) cases each, Abscess in 3 (6%), Galactocoele and lipoma in 2 (4%) cases each, Benign Papillary Neoplasm and Infiltrating Ductal Carcinoma G-II in 1 (2%) case each. Clinical diagnosis of palpable breast masses showed that, carcinoma was observed in 27 (54%) cases, Fibroadenoma 20 (40%) cases, Galactocoele in 2 (4%) cases and Metastalgia in 1 (2%) cases. 
Conclusion: Ultrasound with colour Doppler is safe, relatively inexpensive, widely available, free of radiation hazards, non-invasive essential modality for evaluation of breast lesions and should be one of the first investigations for evaluating a breast lesion before proceeding to aggressive invasive procedures.

Keywords: Breast ultrasound, Resistive index, Pulsatality index spectral doppler and Ultrasound guided FNAC.


Full Text:

PDF