Contribution of microflow imaging to diagnosis in breast lesions

Purpose: Breast cancer, which is the most common cancer in women, is the second most common cancer worldwide, regardless of gender. The positivity rate for the cancer in biopsies performed today varies between 10-31%. In other words, 70-90% of biopsies are performed on benign lesions. Therefore, it is important to classify breast lesions appropriately and avoid unnecessary biopsies. The aim of our study is to investigate the contribution of a new method imaging, microflow imaging (MFI), to the distinction of benign-malignant breast lesions. Materials and Methods: After obtaining ethics committee approval from our institution, 109 lesions of 104 patients who were referred to our clinic for breast biopsy between November 2021 and November 2023 were included in the study and the study was conducted prospectively. B-mode ultrasonography (US), color Doppler ultrasonography (CDUS), power Doppler ultrasonography (PDUS) and MFI examinations were performed on all lesions and B-mode US findings were classified according to the BI-RADS category. CDUS, PDUS and MFI findings were classified according to the ADLER method. In our study; sensitivity, specificity, negative predictive values and positive predictive values of Doppler US imaging methods were calculated. Results: 109 lesions of 104 female patients over the age of eighteen were included in our study. 68 of the lesions were determined as benign and 41 as malignant. From B mode US findings, the border features, orientation features and posterior acoustic features of the lesions were significantly different between malignant and benign lesions. When Doppler examination methods, CDUS, PDUS and MFI findings are categorized according to the ADLER classification and compared between malignant and benign lesions; there was a statistically significant difference in PDUS and MFI findings between benign and malignant breast lesions. The results evaluating the diagnostic performance for Doppler tests showed that statistically significant diagnostic evaluation could be made with PDUS and MFI examinations. When positive and negative predictive values were examined, negative predictive values were higher than positive predictive values in all three Doppler US examination viii methods. These examination methods were found to be more likely to identify benign lesions. Conclusion: Since there is a statistically significant difference between malignant and benign lesions in the vascular evaluation findings made with MFI and PDUS, PDUS and MFI can be used as a criterion in the distinction between benign and malignant breast lesions. By monitoring benign breast lesions with these criteria, unnecessary biopsies can be prevented, treatment costs, patient treatment time and patient anxiety can be reduced. Key Words: Breast cancer, microflow imaging, color Doppler US, power Doppler US