| Purpose: Color Doppler ultrasonography can reflect morphology characteristic and haemodynamics state of breast tumor vascularity through acquiring Doppler frequency shift information. However, inernal and external research in breast cancer focused on blood flow in intratumoral blood vessels. The main arteries to the breast are lateral thoracic artery and internal thoracic artery. We compared the intraindividual differences of Doppler indices in the lateral thoracic artery and internal thoracic artery of breasts affected by cancer with thoese unaffected by disease to evaluate the role of Doppler indices in the diagnosis of breast cancer. The purpose is provide more valuable information in early diagnosis of breast cancer.Materials and Methods: Between Augest 2005 and October 2006, seventy breast tumor patients (mean age of 48.1 years, range 16-80 years) from the first affiliated hospital of Dalian medical university were recruited in this study. None of the women had a history of breast surgery or breast irradiation. The final diagnosis for each patient was obtained by means of histological examination of biopsy specimens (obtained with operative excision). Thirty volunteers were known to be without any breast disease and served as controls. All patients included in this study were examined in one week before surgery by Color Doppler ultrasound. The Color-Doppler mapping was performed with Philips HDI 3000, Envisor and with transducer frequency 5-12MHz. Following standard B-mode studies, areas of interest and the immediately adjacent tissues were scanned with Color Doppler flow imaging and energies Doppler imaging in different planes to assess their vascularity, then, the Doppler probe was positioned at the edge of thepectoral muscle and parasternally between the 2nd and 3nd intercostal. If a persistent Color Doppler signal indicative of the lateral thoracic artery and internal thoracic artery were identified, the spectral Doppler gate was positioned, and spectral tracings of the arterial signals were recorded and analyzed. We calculated the pulsatility index (PI), resisitance index (RI) and systolic/diastolic ratio (S/D ratio) by means of the equipments software.Results:1. The lateral thoracic artery could be visualized in thirty healthy women. There was no statistically significant difference between two sides.2. Doppler indices in women with cancer(n=37), the mean(±standard deviation)S/D ratios, PI, RI of the lateral thoracic arteries were significantly lower in the tumor affected breasts than the contralateral healthy breasts(P<0.05). However, there are no significant difference in benign breast tumor. Using the intraindividual differences(the difference between the cancerous breast and the healthy contralateral breast) to screen for breast cancer, when the difference in S/D ratio between the LTA of the affected vs. the contralateral breast was≥1.5, sensitivity, specificity and positive predictive value(PPV) yielded levels of 83.8%, 83.3% and 86.1%, respectively; when the difference in PI between the LTA of the affected vs. the contralateral breast was≥0.3, sensitivity, specificity and PPV yielded levels of 83.7%,83.3%,86.1%, respectively; when the difference in RI between the LTA of the affected vs. the contralateral breast was≥0.06, sensitivity, specificity and PPV reach 86.4%, 90%, 91.4%.3. In patient with breast cancer, mean values of lateral thoracic were correlated with tumor size, the number of flow signals while were not significantly correlated with age and tumor position.4. Values of internal thoracic arteries were not significantly influenced by both breast cancer and benign breast tumor.Conclusions:1. Color Doppler ultrasonography of the LTA of the affected breast compared to the LTA of the healthy breast does provide helpful information in diagnostic work-up of our patient.2. Though internal thoracic artery is main breast-feeding artery, there is no help in diagnosis of breast cancer. The value of rami perforatesarteriarum intercostalium of internal thoracic artery in the diagnosis of breast cancer should be further explored.3. In patient with breast cancer, mean values of lateral thoracic were negative correlated with tumor size, the number of flow signals, while there were no significantly correlated with age and tumor position. |
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