Breast ultrasound blood flow signal

Breast disease is a relatively common phenomenon. The most obvious symptoms of breast disease are swelling and pain, nodules, etc. There are many causes of breast disease. Bad emotions and irregular living habits will have an impact on breast health. Generally, breast examinations include B-ultrasound or color ultrasound, which can better check the health of the breasts. However, some women have blood flow signals after breast color ultrasound. What is going on?

When women undergo breast B-ultrasound or color ultrasound, the ultrasound description in the report results usually includes the item "CDFI", followed by a description of the blood flow signal.

Blood flow signal, that is, the richness of blood flow.

The presence of blood flow means that there are abundant blood vessels around the tumor, and the tumor will grow faster.

Evaluation criteria for blood flow of tumors in breast color Doppler ultrasound

Alder grading standard: It is a semi-quantitative method for judging the richness of blood vessels. The criteria are as follows: ① Grade 0: no blood flow; ② Grade I: a small amount of blood flow; ③ Grade II: moderate blood flow, with one main blood vessel or several small blood vessels visible at the same time; ④ Grade III: abundant blood flow, with more than four blood vessels visible.

Other criteria: ① No obvious blood flow signal (equivalent to A

II level); ④ Rich (equivalent to Alder III level).

The growth of breast cancer is accompanied by the formation of blood vessels within the tumor. The number of blood vessels and blood supply are relatively abundant. This feature is of certain value in the differential diagnosis of benign and malignant breast tumors.

There is a close relationship between the distribution of tumor blood vessels and the growth and invasion of tumors. Although the new blood vessels shown by color Doppler flow imaging (CDFI) cannot completely match the microscopic manifestations of tumor pathology, it can still show some larger blood vessels with significant characteristics. It is of great significance to use color Doppler flow imaging to analyze the distribution characteristics of tumor blood vessels.

Therefore, for masses with rich or abundant blood flow signals and Alder grade II or above, surgical biopsy is recommended. If the mass is clinically considered to be benign (such as a solid mass with clear boundaries, oval shape, smooth edges, and parallel growth, it is most likely a fibroadenoma), and the patient is temporarily unwilling to undergo surgery, it is recommended to have a follow-up examination in the short term. If the mass is enlarged during the follow-up examination, surgical biopsy is still required.

Why is it that the pathological results after surgery are benign when there are abundant blood flow signals inside and around the breast mass? Why is it that the pathological results after surgery are malignant when there is no obvious blood flow inside and around the mass?

There is a certain overlap in the degree of blood flow between different benign and malignant tumors. Fast-growing fibroadenomas, adolescent fibroadenomas, phyllodes tumors or intraductal papilloma are often easily misdiagnosed as malignant tumors due to their abundant blood flow, resulting in false positives; while ductal carcinomas or lobular carcinomas with obvious fibrous tissue hyperplasia, and small breast cancers with a diameter of less than 10 mm are misdiagnosed as benign tumors because of the extremely thin new blood vessels and extremely low blood flow rate, resulting in false negatives.

Moreover, the size of the tumor, the attenuation behind the tumor, and the signs of internal necrotic liquefaction area may affect the monitoring of blood flow in breast cancer by color Doppler ultrasound. The blood flow parameters detected by ultrasound cannot be used as a direct and effective basis for the differential diagnosis of benign and malignant breast tumors.

In addition, the detection of blood flow by color Doppler ultrasound is affected by the following factors: 1. the influence of the equipment; 2. the influence of the probe frequency and condition settings; 3. the influence of the doctor's operating techniques and experience. If the pressure is too high during the scanning process, the blood flow information will be reduced or disappear, thereby increasing the blood flow resistance index of the artery inside the tumor.

Whether the blood flow signals inside and around the mass provided by breast color ultrasound are rich is only one indicator among the many ultrasonic signs of breast masses in breast color ultrasound examination, and cannot be used alone as a direct and effective basis for differential diagnosis of benign and malignant breast masses.

During breast color ultrasound, if abundant blood flow is found inside and around the tumor, surgery is required, but it is not necessarily breast cancer; if no obvious blood flow signal is found or only a small amount of blood flow signal or star-shaped blood flow signal is seen, it is not necessarily a benign tumor. Whether surgery is needed is determined by a breast specialist who will make a comprehensive analysis based on your medical history, clinical manifestations, breast color ultrasound, breast mammography X-ray or MRI results to decide whether you need a surgical biopsy.

The differentiation of benign and malignant breast lumps requires a combination of the clinician's palpation, medical history, two-dimensional ultrasound manifestations of breast color Doppler ultrasound, and evaluation combined with color Doppler blood flow information, elastic hardness, ultrasound angiography, etc., and, if necessary, combined with breast mammography X-ray, MRI or other examinations for comprehensive analysis.