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Tumor Vascularity of Breast Lesions

Potentials and Limits of Contrast-Enhanced Doppler Sonography

¹ All authors: Röntgenabteilung, Gemeinschaftskrankenhaus Herdecke, Universität Witten-Herdecke, Beckweg 4, 58313 Herdecke, Germany.

View larger version (14K): [in a new window]   Fig. 1. —Drawings show basic patterns of tumor vascularization: type 1 (not shown) is avascular type with no obvious vascularization. Type 2 is benign type, with individual, roughly same size, monomorphic vessels (left) or vessels running around edge of tumor, which is regular course of vessels (right). Type 3 is malignant-type irregularly configured vessels varying in size, occasionally fusing in color grading to pools (left) or irregularly running vessels that approach or penetrate tumor (right).

View larger version (164K): [in a new window]   Fig. 2A. —47-year-old woman who underwent breast-sparing surgery 19 months earlier. Patient presented with suspected multifocal tumor recurrence because of two palpable lumps in scar from surgery and at separate location near scar. B-mode sonograms reveal two echo-poor lesions. Color-coded Doppler sonography (not shown) did not show any vessels.

View larger version (194K): [in a new window]   Fig. 2B. —47-year-old woman who underwent breast-sparing surgery 19 months earlier. Patient presented with suspected multifocal tumor recurrence because of two palpable lumps in scar from surgery and at separate location near scar. B-mode sonograms reveal two echo-poor lesions. Color-coded Doppler sonography (not shown) did not show any vessels.

View larger version (188K): [in a new window]   Fig. 2C. —47-year-old woman who underwent breast-sparing surgery 19 months earlier. Patient presented with suspected multifocal tumor recurrence because of two palpable lumps in scar from surgery and at separate location near scar. Contrast-enhanced sonogram shows that one lesion still has no obvious vascularization. Histopathology (not shown) confirmed scar.

View larger version (168K): [in a new window]   Fig. 2D. —47-year-old woman who underwent breast-sparing surgery 19 months earlier. Patient presented with suspected multifocal tumor recurrence because of two palpable lumps in scar from surgery and at separate location near scar. Contrast-enhanced sonogram of other lesion shows pathologic tumor vascularization with irregularly configured vessels varying in size. Histopathology (not shown) confirmed tumor recurrence (invasive ductal carcinoma).

View larger version (141K): [in a new window]   Fig. 3. —53-year-old woman with invasive ductal carcinoma. Doppler sonogram shows malignant type 3 vascularization pattern, with deep vessels penetrating tumor and following irregular course.

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