Abstract

Background: The present study was conducted to investigate the diagnostic value of spectral Doppler ultrasound in determining malignant potential of breast masses. Methods: The dedicate dB-mode and Doppler (including color and spectral) breast ultrasound examinations were performed on 100 consecutive women with breast mass (mean age = 45.02 years). The findings were compared between benign (n = 65) and malignant (n = 35) groups, regarding the histopathologic results. Receiver operating characteristic (ROC) curve was used to determine the optimal cut-off point for each spectral Doppler index. Results: On B-mode ultrasound, malignant breast masses tended to have bigger size, irregular and ill-defined border, cystic components, and mixed echogenicity (P < 0.001 for all characteristics). On color Doppler study, detectable flow was more common in malignant tumors compared to benign lesions (74.1 vs. 21.9, P < 0.0001). All spectral Doppler indices, including mean peak systolic velocity (PSV), resistive index (RI), and pulsatility index (PI) were significantly higher in malignant tumors. All of these indices had high diagnostic accuracy for differentiating malignant tumors from benign lesions with area under the curve (AUC) equals to 0.79, 0.78, and 0.90 for PSV, RI, and PI, respectively. The optimal cut-off points were PSV = 12.5 cm/s (sensitivity: 75, specificity: 71.4), RI = 0.68 (sensitivity = 85, specificity = 74), and PI = 0.93 (sensitivity = 90, specificity = 85.7). Conclusions: Doppler examination has a significant role in the evaluation of breast masses and adds value to the B-mode ultrasound for distinguishing malignant tumors from benign lesions.