Achados na ultrassonografia combinada ao doppler colorido comparados ao diagnóstico histopatológico de carcinoma de mama

• Autor(a) principal: Cruz, Maria de Fátima Saraiva Gonçalves
• Data de Publicação: 2019
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal do Ceará (UFC)
• Texto Completo: http://www.repositorio.ufc.br/handle/riufc/49686
• topic: Neoplasias da Mama; Ultrassonografia; Ultrassonografia Doppler em Cores

Breast cancer is a type of cancer that most affects women worldwide, in both developing and developed countries. Angiogenesis plays an important role in cancer development and progression, including breast cancer. Breast ultrasound has been considered an effective complementary method to mammography in breast cancer screening. To improve the positive predictive value, color Doppler may be included in the ultrasound examination to identify the presence of tumor vessels and to classify them for their distribution and morphology. This method is widely used for the evaluation of vascularity in breast lesions, but there is no standardization of criteria in the Doppler evaluation to classify malignancy or benignity. A cross-sectional study was performed with a total of 115 women, treated at the Assis Chateaubriand Maternity Mastology Outpatient Clinic, from September 2018 to August 2019. Nodes classified as BI-RADS 4 or 5 were biopsied by core biopsy. Of the 115 biopsied nodules, 27 were malignant and 88 benign. The aim of the study is to identify sonographic features associated with color Doppler in proven breast cancer cases and to show whether there are criteria in the study of the internal vascularization of the lesion that is associated with a positive histological diagnosis for breast cancer. Regarding the presence or absence of internal vascularization in the nodules, there was a significant association with a diagnosis of malignancy (p = 0.012). Of the 27 malignant nodules, 61% had internal vascularization. The study showed high sensitivity (96%) and low specificity (56%).The positive predictive value of 40% and the negative predictive value of 98%. In the multivariate analysis, with the variables of internal vascularization distribution type, the presence of central distribution presented an odds ratio (OR) of 13.58 (3.96-46.51) (p <0.001). For the presence of peripheral distribution vascularization, the OR was 5.96 (1.53 - 23.24) (p: 0.01). In the multivariate analysis of the nodule internal vessel morphology variable, the penetrating type showed a significant association with positive histopathological diagnosis (OR: 23.19 [7.07-75.99], p <0.001). Regarding the analysis of the spectral curve in the present study, it was observed that lesions with positive histopathological results for malignancy presented higher resistance index (RI), pulsatility index (PI) and systolic peak when evaluated by the Mann test. -Whitney, with p <0.0001. The results of the present study demonstrate that one can identify characteristics ultrasound combined with color Doppler in histopathologically proven cases of breast cancer.