Solid breast neoplasms: differential diagnosis with pulsed Doppler ultrasound

In this prospective study, duplex Doppler ultrasound was used in 95 consecutive patients with solid breast masses to evaluate the presence of neovascular flow. A positive Doppler signal, i.e., a Doppler shift frequency of more than 1 kHz using a 5 MHz insonating frequency, was found in 34 of 57 patients with a carcinoma, and also in three patients with a benign condition. These results indicate that negative findings with pulsed Doppler ultrasound cannot be used to exclude malignancy. However, a frequency shift of more than 1 kHz indicates a high probability for malignancy. In our study a high frequency shift was not related to tumor size. We also evaluated the correlation between a high frequency shift and axillary nodal metastasis. According to our results there is a very low chance of axillary metastasis when no high frequency shifts are found.