DIAGNOSTIC ACCURACY OF SPECTRAL DOPPLER ULTRASOUND IN DETECTING SOLID BREAST LESION MALIGNANCY TAKING HISTOPATHOLOGY AS A GOLD STANDARD

Authors

  • Muhammad Ahmad Raza Al-Razi Institute, Lahore, Pakistan Author https://orcid.org/0009-0002-2932-8424
  • Saira Ghaffar University of Lahore, Pakistan Author
  • Muhammad Kaleem Akhter University of Lahore; Mayo Hospital, Lahore, Pakistan Author
  • Syeda Alina Sherazi Green International University, Lahore, Pakistan Author
  • Sidra Ghazanfar University of Lahore, Pakistan Author
  • Noor Fatima Superior University, Lahore, Pakistan Author
  • Muhammad Yasir Aziz University institute of radiological sciences & MIT, University of Lahore, Pakistan Author
  • Raheel Abrar University of Lahore, Pakistan Author

DOI:

https://doi.org/10.71000/aemw1040

Keywords:

Histopathology, Breast Neoplasms, Diagnostic Imaging, Doppler Ultrasonography, Predictive Value of Tests, Sensitivity and Specificity, Ultrasound Imaging

Abstract

Background: Breast cancer remains the most prevalent malignancy among women globally and a major contributor to cancer-related mortality. In Pakistan, the burden of breast cancer continues to rise, with late-stage diagnosis being a common challenge. Early and accurate identification of malignancy in breast lesions is critical for improving outcomes. Spectral Doppler ultrasonography, a non-invasive modality, offers valuable insight into vascular patterns of breast masses and may enhance diagnostic accuracy when used alongside B-mode ultrasound.

Objective: To determine the diagnostic accuracy of spectral Doppler ultrasound in detecting malignancy in solid breast lesions, using histopathology as the gold standard.

Methods: This prospective observational study was conducted at the Radiology Department of Al-Razi Institute, Lahore. A total of 190 female patients aged 18–60 years, presenting with breast lesions categorized as BI-RADS III, IV, or V, were enrolled. After obtaining informed consent, each participant underwent spectral Doppler ultrasonography, followed by an ultrasound-guided core biopsy using an 18-gauge Trucut needle. Histopathological analysis was performed on formalin-preserved cores by a fellowship-trained consultant histopathologist. Diagnostic parameters, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy, were calculated by comparing Doppler findings with histopathology.

Results: Spectral Doppler ultrasonography identified malignancy in 86 cases (45.3%), while histopathology confirmed 90 cases (47.4%). The modality demonstrated 83.9% sensitivity, 95.5% specificity, 88.7% PPV, 93.4% NPV, and an overall diagnostic accuracy of 92.1%. Age-stratified and BI-RADS subgroup analyses further supported the high diagnostic value of Doppler imaging.

Conclusion: Spectral Doppler ultrasound is a reliable, accessible, and non-invasive diagnostic tool for differentiating benign from malignant solid breast lesions, offering high diagnostic accuracy when histopathology is unavailable or delayed.

Author Biographies

  • Muhammad Ahmad Raza, Al-Razi Institute, Lahore, Pakistan

    Lecturer, Al-Razi Institute, Lahore, Pakistan

  • Saira Ghaffar, University of Lahore, Pakistan

    Bachelor of Medical Imaging Sciences, University of Lahore, Pakistan

  • Muhammad Kaleem Akhter, University of Lahore; Mayo Hospital, Lahore, Pakistan

    MS Diagnostic Ultrasound, University of Lahore; Mayo Hospital, Lahore, Pakistan

  • Syeda Alina Sherazi, Green International University, Lahore, Pakistan

    Master of Science, Green International University, Lahore, Pakistan

  • Sidra Ghazanfar, University of Lahore, Pakistan

    University Institute of Radiological Sciences & Medical Imaging Technology, University of Lahore, Pakistan

  • Noor Fatima, Superior University, Lahore, Pakistan

    BSMIT, Department of Radiological Sciences & Medical Imaging Technology, Superior University, Lahore, Pakistan

  • Muhammad Yasir Aziz, University institute of radiological sciences & MIT, University of Lahore, Pakistan

     Lecturer & Research coordinator, University institute of radiological sciences & MIT, University of Lahore, Pakistan

  • Raheel Abrar, University of Lahore, Pakistan

    University institute of radiological sciences & MIT, University of Lahore, Pakistan

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Published

2025-05-12