86 P - Usefulness of color doppler in assessing breast intracystic or intraductal solid lesions

Abstract

The visualization of solid, echogenic content within a cystic lesion or a dilated duct poses the diagnostic problem of differentiating debris and clots versus a solid disorder. We used Color Doppler (CD) to asses vascular abnormalities within intracystic and intraductal lesions. Between January and November 1995 we encountered 48 complex cystic lesions and 9 dilated ducts with echogenic material. We used high frequency US probes (10 or 13 MHz) to assess the lesions and we also performed CD with low PRF (500Hz) to detect slow flow. All the patients underwent US guided aspiration biopsy of the complex cistic lesion with the tip of the needle carefully directed within the echogenic portion. In 39 cases the CD was negative as well as the cytological exam. Nine CD-positive cases were associated with 7 papillomas and 2 carcinomas and underwent surgery. Blood flow signal had been detected in 3 of the 4 cases with papilloma, while one was falsely negative. Two small cystic lesions (diameter less than 7mm) showed a clear CD signal, due to an artefactual intralesion projection of a nerby running vessel: the cytology was negative. We think that CD should always be performed in the assesment of intracystic and intraductal solid projections, but a better sensitivity to flow in small blood vessels is still needed.