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Benign and Malignant Breast Masses and Axillary Nodes: Evaluation with Echo-enhanced Color Power Doppler US¹

¹ From the Department of Diagnostic Radiology and Organ Imaging (W.T.Y., C.M.) and the Center for Clinical Trials and Epidemiological Research (P.K.W.L.), Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong; and the Breast Care Center, Baylor College of Medicine, Houston, Tex (J.C.). Received September 18, 2000; revision requested November 2; final revision received March 15, 2001; accepted March 19. Supported in part by the University Grants Council Direct Grant for Research, Chinese University of Hong Kong, project code 2040753 and a research grant from Schering, Berlin, Germany. Address correspondence to W.T.Y. (e-mail: weitsetan@cuhk.edu.hk).

PURPOSE: To evaluate microbubble contrast enhancement in distinguishing malignant from benign breast masses and malignant from benign axillary nodes in patients with breast cancer.

MATERIALS AND METHODS: Eighty-six patients with 86 breast masses and 32 patients with breast cancer (subgroup of 86 patients) with 32 axillary nodes underwent color power Doppler ultrasonography with and without contrast material. Vascular features and contrast material transit times were recorded. Nodal enhancement was compared with corresponding primary breast cancer enhancement in the subset of 32 patients.

RESULTS: Pathologic analysis revealed 58 breast carcinomas and 28 benign breast lesions and 20 malignant and 12 benign axillary nodes in the 32 patients with breast cancer. Breast cancers had a greater total number and greater number of peripheral vessels than did benign lesions before and after contrast material administration (P < .001). Malignant nodes had a greater total number and greater number of peripheral vessels at baseline and after contrast enhancement (P < .05), and a longer enhancement duration (P = .004) compared with benign nodes. Malignant nodes enhanced more than did corresponding primary breast cancers. Postcontrast number of peripheral vessels was an independent predictor of primary breast cancer (P < .05), and increased number of peripheral vessels after contrast enhancement and enhancement duration were independent predictors of nodal malignancy (P < .05).

CONCLUSION: Primary breast cancers and malignant axillary nodes had a greater total number and greater number of peripheral vessels compared with benign breast masses and axillary nodes, respectively.

Index terms: Breast neoplasms, 00.31, 00.32 • Breast neoplasms, US, 00.12983, 00.12984, 00.12985, 00.12988 • Lymphatic system, US, 99.12983, 99.12984, 99.12985, 99.12988 • Ultrasound, Doppler studies, 00.12983, 00.12984, 00.12985, 00.12988, 99.12983, 99.12984, 99.12985, 99.12988

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