ABSTRACT
To evalute the role of colour doppler sonography [CDS] in the differential diagnosis of breast lesions prospective study of 104 patients who underwent breast imaging diagnostic techniques from January 1995 to December 1997 was done. A good history and clinical examination were conducted to all patients. Mammography and conventional ultrasonography were done firstly as a preliminary test, then colour doppler sonography was done to all patients for examination of all lesions detected by mammography and/or ultrasonography and completed by examination of the whole diseased breast and the contralateral breast especially the corrosponding area to the lesion as a control. All the detected breast lesions were excised surgically and their pathological results were obtained and proved that 38 lesions were benign while 66 ones were malignant. Mammography showed an accuracy of 84.2% for benign and 83.4 for malignant lesions with a 6% false positive and 3% false negative. Ultrasonography showed an accuracy of 78.9% for benign and 74.2% for malignant lesions with a 7.6% false positive and 10.5% false negative. Colour doppler sonography showed an accuracy of 76.3 for benign and 77.3% for malignant lesions with a 3% false positive and 5.3% fasle negative. Malignant lesions were characteristically more vascular than the benign ones because they stimulate the growth of new blood vessels by secreting angiogenesis factors. Most malignant lesions had more than 3 blood vessels either within the lesion or at its periphery while the benign ones even the largest had no more than 3 vessels. Malignant vessels are usually tortuous, larger, and occur away from the site of normal vessels. The maximum velocity of blood flow was much higher in malignant lesions [mean 31.2 cm/sec] than benign ones [mean 18.9 cm/sec]. Systolic/diastolic [S/D] ratio and resistance index [RI] of the flowing blood were estimated for all lesions and were non specific in all values. We concluded that colour doppler sonography is a new promising technique, non invasive, fast, easy and safe. Its of great value in differential diagnosis of breast lesions and helps in diagnosis of their local and distant extention to lymph nodes. A triple imaging technique [combined use of mammography, conventional ultrasonography and colour doppler sonography is considered an ideal pathway in differential diagnosis of breast lesions, with an accuracy nearly to 100%, helps to avoid the false positive and negative results and reduces the number of unnecessary biopsies. It can be used as a routin procedure in the programs of screening, early detection and diagnosis of breast lesions