Role of Duplex Ultrasound for the Assessment of Malignancy in Breast Tumors

Anindita Rani Paul; Faria Nasreen; Nasreen Sultana

doi:doi:10.11648/j.crj.20190704.14

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Role of Duplex Ultrasound for the Assessment of Malignancy in Breast Tumors

Anindita Rani Paul, Faria Nasreen, Nasreen Sultana

Published in Cancer Research Journal (Volume 7, Issue 4)

Received: 15 September 2019 Accepted: 14 October 2019 Published: 23 October 2019

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Abstract

Background: Breast cancer is the commonest form of cancer in females which may be curable if detected early. Breast ultrasound (US) is a non invasive, primary screening tool which can evaluate breast tumors in women even with dense breast. By adding color Doppler signal with B-mode US namely Duplex ultrasound better characterization of breast tumors is possible especially for the indeterminate tumors (BIRADS category 3 and 4) on B-Mode US. Objective: The purpose of this study is to assess the efficacy of Duplex Sonography (DS) for assessment of malignancy in breast tumors compared to histopathology. Materials and methods: This cross-sectional study was carried out at National Institute of Nuclear Medicine & Allied Science (NINMAS) from July 2017 to June 2018. A total of 57 female patients having breast tumors (age mean 42.09 years with SD ± 15.85) were included in this study. After clinical assessment, all study patients underwent Duplex Ultrasound and was then subjected to the excisional biopsy and histopathology for confirmation of the diagnosis. Diagnostic performance test of DS was done for diagnosis of breast malignancy compared to histopathology. Receiver-operator characteristic (ROC) curve was also constructed to determine the optimal cut-off point for each spectral Doppler indices. Results: On Color Doppler Sonography (CDS), hypervascularity was more common in malignant tumors than benign lesions (86.7%Vs 18.5%; p=0.001). Spectral Doppler indices including resistive index (RI) and pulsatility index (PI) were significantly higher in malignant tumors (p=0.001). All of these indices had high diagnostic accuracy for differentiating malignant from benign tumors with area under the curve (AUC) which is equals to 0.90, 0.92 for RI and PI respectively. The optimal cut-off points to differentiate benign and malignant tumors from ROC curve for RI was 0.75 (sensitivity: 89.0%, specificity: 85.0%) and that of PI was 1.2 (sensitivity: 96.6%, specificity: 80.0%). All obtained results of sensitivity, specificity and over all accuracy of DS (considering the vessel number on CDS & BIRADS criteria on B-mode US) were 93.3%, 81.5% and 87.7% respectively. Conversely, conventional B-Mode US alone had a sensitivity, specificity and over all accuracy of 100%, 55.6%, and 78.9% respectively. Addition of CDS to B-mode US in the same session increased specificity from 55.6% to 81.5% and accuracy from 78.9% to 87.7%. Conclusion: Duplex ultrasound has a significant role in the evaluation of breast tumors and adds value to B-mode US for distinguishing malignant tumors from benign lesions.

Published in	Cancer Research Journal (Volume 7, Issue 4)
DOI	10.11648/j.crj.20190704.14
Page(s)	143-149
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Breast Cancer, Ultrasound (US), Color Doppler Sonography (CDS), Duplex Sonography (DS), Resistive Index (RI), Pulsatility Index (PI)

References

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Anindita Rani Paul, Faria Nasreen, Nasreen Sultana. (2019). Role of Duplex Ultrasound for the Assessment of Malignancy in Breast Tumors. Cancer Research Journal, 7(4), 143-149. https://doi.org/10.11648/j.crj.20190704.14

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Anindita Rani Paul; Faria Nasreen; Nasreen Sultana. Role of Duplex Ultrasound for the Assessment of Malignancy in Breast Tumors. Cancer Res. J. 2019, 7(4), 143-149. doi: 10.11648/j.crj.20190704.14

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Anindita Rani Paul, Faria Nasreen, Nasreen Sultana. Role of Duplex Ultrasound for the Assessment of Malignancy in Breast Tumors. Cancer Res J. 2019;7(4):143-149. doi: 10.11648/j.crj.20190704.14

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@article{10.11648/j.crj.20190704.14,
  author = {Anindita Rani Paul and Faria Nasreen and Nasreen Sultana},
  title = {Role of Duplex Ultrasound for the Assessment of Malignancy in Breast Tumors},
  journal = {Cancer Research Journal},
  volume = {7},
  number = {4},
  pages = {143-149},
  doi = {10.11648/j.crj.20190704.14},
  url = {https://doi.org/10.11648/j.crj.20190704.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.crj.20190704.14},
  abstract = {Background: Breast cancer is the commonest form of cancer in females which may be curable if detected early. Breast ultrasound (US) is a non invasive, primary screening tool which can evaluate breast tumors in women even with dense breast. By adding color Doppler signal with B-mode US namely Duplex ultrasound better characterization of breast tumors is possible especially for the indeterminate tumors (BIRADS category 3 and 4) on B-Mode US. Objective: The purpose of this study is to assess the efficacy of Duplex Sonography (DS) for assessment of malignancy in breast tumors compared to histopathology. Materials and methods: This cross-sectional study was carried out at National Institute of Nuclear Medicine & Allied Science (NINMAS) from July 2017 to June 2018. A total of 57 female patients having breast tumors (age mean 42.09 years with SD ± 15.85) were included in this study. After clinical assessment, all study patients underwent Duplex Ultrasound and was then subjected to the excisional biopsy and histopathology for confirmation of the diagnosis. Diagnostic performance test of DS was done for diagnosis of breast malignancy compared to histopathology. Receiver-operator characteristic (ROC) curve was also constructed to determine the optimal cut-off point for each spectral Doppler indices. Results: On Color Doppler Sonography (CDS), hypervascularity was more common in malignant tumors than benign lesions (86.7%Vs 18.5%; p=0.001). Spectral Doppler indices including resistive index (RI) and pulsatility index (PI) were significantly higher in malignant tumors (p=0.001). All of these indices had high diagnostic accuracy for differentiating malignant from benign tumors with area under the curve (AUC) which is equals to 0.90, 0.92 for RI and PI respectively. The optimal cut-off points to differentiate benign and malignant tumors from ROC curve for RI was 0.75 (sensitivity: 89.0%, specificity: 85.0%) and that of PI was 1.2 (sensitivity: 96.6%, specificity: 80.0%). All obtained results of sensitivity, specificity and over all accuracy of DS (considering the vessel number on CDS & BIRADS criteria on B-mode US) were 93.3%, 81.5% and 87.7% respectively. Conversely, conventional B-Mode US alone had a sensitivity, specificity and over all accuracy of 100%, 55.6%, and 78.9% respectively. Addition of CDS to B-mode US in the same session increased specificity from 55.6% to 81.5% and accuracy from 78.9% to 87.7%. Conclusion: Duplex ultrasound has a significant role in the evaluation of breast tumors and adds value to B-mode US for distinguishing malignant tumors from benign lesions.},
 year = {2019}
}

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TY - JOUR
T1 - Role of Duplex Ultrasound for the Assessment of Malignancy in Breast Tumors
AU - Anindita Rani Paul
AU - Faria Nasreen
AU - Nasreen Sultana
Y1 - 2019/10/23
PY - 2019
N1 - https://doi.org/10.11648/j.crj.20190704.14
DO - 10.11648/j.crj.20190704.14
T2 - Cancer Research Journal
JF - Cancer Research Journal
JO - Cancer Research Journal
SP - 143
EP - 149
PB - Science Publishing Group
SN - 2330-8214
UR - https://doi.org/10.11648/j.crj.20190704.14
AB - Background: Breast cancer is the commonest form of cancer in females which may be curable if detected early. Breast ultrasound (US) is a non invasive, primary screening tool which can evaluate breast tumors in women even with dense breast. By adding color Doppler signal with B-mode US namely Duplex ultrasound better characterization of breast tumors is possible especially for the indeterminate tumors (BIRADS category 3 and 4) on B-Mode US. Objective: The purpose of this study is to assess the efficacy of Duplex Sonography (DS) for assessment of malignancy in breast tumors compared to histopathology. Materials and methods: This cross-sectional study was carried out at National Institute of Nuclear Medicine & Allied Science (NINMAS) from July 2017 to June 2018. A total of 57 female patients having breast tumors (age mean 42.09 years with SD ± 15.85) were included in this study. After clinical assessment, all study patients underwent Duplex Ultrasound and was then subjected to the excisional biopsy and histopathology for confirmation of the diagnosis. Diagnostic performance test of DS was done for diagnosis of breast malignancy compared to histopathology. Receiver-operator characteristic (ROC) curve was also constructed to determine the optimal cut-off point for each spectral Doppler indices. Results: On Color Doppler Sonography (CDS), hypervascularity was more common in malignant tumors than benign lesions (86.7%Vs 18.5%; p=0.001). Spectral Doppler indices including resistive index (RI) and pulsatility index (PI) were significantly higher in malignant tumors (p=0.001). All of these indices had high diagnostic accuracy for differentiating malignant from benign tumors with area under the curve (AUC) which is equals to 0.90, 0.92 for RI and PI respectively. The optimal cut-off points to differentiate benign and malignant tumors from ROC curve for RI was 0.75 (sensitivity: 89.0%, specificity: 85.0%) and that of PI was 1.2 (sensitivity: 96.6%, specificity: 80.0%). All obtained results of sensitivity, specificity and over all accuracy of DS (considering the vessel number on CDS & BIRADS criteria on B-mode US) were 93.3%, 81.5% and 87.7% respectively. Conversely, conventional B-Mode US alone had a sensitivity, specificity and over all accuracy of 100%, 55.6%, and 78.9% respectively. Addition of CDS to B-mode US in the same session increased specificity from 55.6% to 81.5% and accuracy from 78.9% to 87.7%. Conclusion: Duplex ultrasound has a significant role in the evaluation of breast tumors and adds value to B-mode US for distinguishing malignant tumors from benign lesions.
VL - 7
IS - 4
ER -

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Author Information

Anindita Rani Paul

Institute of Nuclear Medical Physics, Atomic Energy Research Establishment (AERE), Savar, Dhaka, Bangladesh
Faria Nasreen

National Institute of Nuclear Medicine & Allied Sciences, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh
Nasreen Sultana

National Institute of Nuclear Medicine & Allied Sciences, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh

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APA Style

Anindita Rani Paul, Faria Nasreen, Nasreen Sultana. (2019). Role of Duplex Ultrasound for the Assessment of Malignancy in Breast Tumors. Cancer Research Journal, 7(4), 143-149. https://doi.org/10.11648/j.crj.20190704.14

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ACS Style

Anindita Rani Paul; Faria Nasreen; Nasreen Sultana. Role of Duplex Ultrasound for the Assessment of Malignancy in Breast Tumors. Cancer Res. J. 2019, 7(4), 143-149. doi: 10.11648/j.crj.20190704.14

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AMA Style

Anindita Rani Paul, Faria Nasreen, Nasreen Sultana. Role of Duplex Ultrasound for the Assessment of Malignancy in Breast Tumors. Cancer Res J. 2019;7(4):143-149. doi: 10.11648/j.crj.20190704.14

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@article{10.11648/j.crj.20190704.14,
  author = {Anindita Rani Paul and Faria Nasreen and Nasreen Sultana},
  title = {Role of Duplex Ultrasound for the Assessment of Malignancy in Breast Tumors},
  journal = {Cancer Research Journal},
  volume = {7},
  number = {4},
  pages = {143-149},
  doi = {10.11648/j.crj.20190704.14},
  url = {https://doi.org/10.11648/j.crj.20190704.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.crj.20190704.14},
  abstract = {Background: Breast cancer is the commonest form of cancer in females which may be curable if detected early. Breast ultrasound (US) is a non invasive, primary screening tool which can evaluate breast tumors in women even with dense breast. By adding color Doppler signal with B-mode US namely Duplex ultrasound better characterization of breast tumors is possible especially for the indeterminate tumors (BIRADS category 3 and 4) on B-Mode US. Objective: The purpose of this study is to assess the efficacy of Duplex Sonography (DS) for assessment of malignancy in breast tumors compared to histopathology. Materials and methods: This cross-sectional study was carried out at National Institute of Nuclear Medicine & Allied Science (NINMAS) from July 2017 to June 2018. A total of 57 female patients having breast tumors (age mean 42.09 years with SD ± 15.85) were included in this study. After clinical assessment, all study patients underwent Duplex Ultrasound and was then subjected to the excisional biopsy and histopathology for confirmation of the diagnosis. Diagnostic performance test of DS was done for diagnosis of breast malignancy compared to histopathology. Receiver-operator characteristic (ROC) curve was also constructed to determine the optimal cut-off point for each spectral Doppler indices. Results: On Color Doppler Sonography (CDS), hypervascularity was more common in malignant tumors than benign lesions (86.7%Vs 18.5%; p=0.001). Spectral Doppler indices including resistive index (RI) and pulsatility index (PI) were significantly higher in malignant tumors (p=0.001). All of these indices had high diagnostic accuracy for differentiating malignant from benign tumors with area under the curve (AUC) which is equals to 0.90, 0.92 for RI and PI respectively. The optimal cut-off points to differentiate benign and malignant tumors from ROC curve for RI was 0.75 (sensitivity: 89.0%, specificity: 85.0%) and that of PI was 1.2 (sensitivity: 96.6%, specificity: 80.0%). All obtained results of sensitivity, specificity and over all accuracy of DS (considering the vessel number on CDS & BIRADS criteria on B-mode US) were 93.3%, 81.5% and 87.7% respectively. Conversely, conventional B-Mode US alone had a sensitivity, specificity and over all accuracy of 100%, 55.6%, and 78.9% respectively. Addition of CDS to B-mode US in the same session increased specificity from 55.6% to 81.5% and accuracy from 78.9% to 87.7%. Conclusion: Duplex ultrasound has a significant role in the evaluation of breast tumors and adds value to B-mode US for distinguishing malignant tumors from benign lesions.},
 year = {2019}
}

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