• Daniela Stanzani, Luciano F Chala, Nestor de Barros, Giovanni G Cerri, and Maria Cristina Chammas.
• Instituto de Radiologia do Hospital das Clínicas da, Faculdade de Medicina da, Universidade de São Paulo, São PauloSP, Brazil, Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo/SP, Brazil.
• Clinics (Sao Paulo). 2014 Feb 1; 69 (2): 87-92.

ObjectivesDespite evidence suggesting that Doppler ultrasonography can help to differentiate between benign and malignant breast lesions, it is rarely applied in clinical practice. The aim of this study was to determine whether certain vascular features of breast masses observed by duplex Doppler and color Doppler ultrasonography (before and/or after microbubble contrast injection) add information to the gray-scale analysis and support the Breast Imaging-Reporting and Data System (BI-RADS) classification.MethodsSeventy solid lesions were prospectively evaluated with gray-scale ultrasonography, color Doppler ultrasonography, and contrast-enhanced ultrasonography. The morphological analysis and lesion vascularity were correlated with the histological results.ResultsPercutaneous core biopsies revealed that 25/70 (17.5%) lesions were malignant, while 45 were benign. Hypervascular lesions with tortuous and central vessels, a resistive index (RI)≥ 0.73 before contrast injection, and an RI≥ 0.75 after contrast injection were significantly predictive of malignancy (p<0.001).ConclusionThe combination of gray-scale ultrasonography data with unenhanced or enhanced duplex Doppler and color Doppler US data can provide diagnostically useful information. These techniques can be easily implemented because Doppler devices are already present in most health centers.

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