Ultrasound evaluation of biopsy proven malignant breast mass


  • Geetanjali Barman Department of Radiodiagnosis, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India
  • Kabita Bujarbaruah Department of Radiodiagnosis, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India
  • Binoy Kumar Choudhury Department of Radiodiagnosis, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India
  • Amal Chandra Kataki Department of Gynecologic Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India




Breast mass, Colour doppler, Invasive Ductal Carcinoma, Malignant, Pulsed doppler, Ultrasound


Background: Breast cancer is the most common malignancy in female worldwide. Ultrasound (US) is a safe and easily available modality for evaluation of breasts in females of all age groups. It can detect characteristic features of breast malignancy with high degree of accuracy. This study was undertaken with the aims to evaluate the ultrasonographic features of malignant breast mass, to identify the most commonly encountered gray scale ultrasound findings and to study the role of Doppler ultrasound in those cases.

Methods: The study was conducted in Dr B. Borooah Cancer Institute, Guwahati from January 2018 to January 2019. Gray scale ultrasound including Doppler study was done in all the female patients coming with palpable breast lump or with nipple discharge and images were archived. The archived images of a total number of 108 patients with biopsy report positive for malignancy were retrospectively studied and the ultrasound findings were evaluated.

Results: Most common gray scale ultrasound features for malignant breast masses were hypoechoic mass, taller than wide, irregular shape, having spiculated margins, neither posterior acoustic enhancement nor shadowing, presence of intralesional microcalcifications and surrounding echogenic halo. Hypervascularity, noticeable difference in waveform pattern between central and peripheral vessels, high resistance flow pattern with absent or reversal of diastolic flow were the common Doppler findings.

Conclusions: Combination of Doppler with gray scale ultrasound has emerged as a very important technique in diagnosing malignant breast mass with high accuracy.


Malvia S, Bagadi SA, Dubey US, Saxena S. Epidemiology of breast cancer in Indian women. Asia‐Pacific J Clin Oncol. 2017 Aug;13(4):289-95.

Khokhar A. Breast cancer in India: where do we stand and where do we go?. Asian Paci J Cancer Preven. 2012;13(10):4861-6.

Hasni H, Meah FA, Norlia A, Sharifah NA, Zulfiqar A. Ultrasound in the assessment of the palpable breast mass. Med J Malaysia. 2004 Oct;59(4):486-94.

Invasive Ductal Cancer (IDC), 2019 Available at : https://www.breastcancer.org/symptoms/types/idc. Accessed 19th Dec 2019.

Gupta K, Kumaresan M, Venkatesan B, Chandra T, Patil A, Menon M. Sonographic features of invasive ductal breast carcinomas predictive of malignancy grade. Ind J Radiol Imag. 2018 Jan;28(1):123.

Benign and malignant characteristics of breast lesions at ultrasound. Available at: https://radiopaedia.org/articles. Accessed 19th Dec 2019.

US of Breast Masses Categorized as BI-RADS 3, 4, and 5: Pictorial Review of Factors Influencing Clinical Management1 Available at: https://pubs.rsna.org/doi/pdf/10.1148/rg.305095144. Accessed 20th Dec 2019

Popli MB. Pictorial essay: Mammographic features of breast cancer. Ind J Radiol Imag. 2001 Nov 1;11(4):175.

Sannomiya N, Hattori Y, Ueda N, Kamida A, Koyanagi Y, Nagira H, et al. Correlation between Ultrasound Findings of Tumor Margin and Clinicopathological Findings in Patients with Invasive Ductal Carcinoma of the Breast. Yonago Acta Med. 2016 Jun;59(2):163.

Jalaguier-Coudray A, Thomassin-Piana J. Solid masses: what are the underlying histopathological lesions?. Diag Intervent Imag. 2014 Feb 1;95(2):153-68.

Computer -Aided Measurement of Solid Breast Tumour Features on Ultrasound images Available at: https://www.researchgate.net/publication/221304614_Computer-Aided Measurement of Solid Breast Tumor_Features on Ultrasound_Images. Accessed 20 Dec 2019.

Cosgrove DO, Kedar RP, Bamber JC, al-Murrani BA, Davey JB, Fisher C, et al. Breast diseases: color Doppler US in differential diagnosis. Radiology. 1993 Oct;189(1):99-104.

Keshavarz E, Mehrjardi MZ, Karimi MA, Valian N, Kalantari M, Valian K. Diagnostic value of spectral doppler ultrasound in detecting breast malignancies: An original article. Int J Cancer Manag. 2018;11(2).

del Cura JL, Elizagaray E, Zabala R, Legórburu A, Grande D. The use of unenhanced Doppler sonography in the evaluation of solid breast lesions. Am J Roentgenol. 2005 Jun;184(6):1788-94.

Hashmi A, Ackerman S, Irshad A. Color Doppler sonography: characterizing breast lesions. Imag Med. 2010 Apr 5;2(2):151-63.

Stanzani D, Chala LF, Barros ND, Cerri GG, Chammas MC. Can Doppler or contrast-enhanced ultrasound analysis add diagnostically important information about the nature of breast lesions?. Clinics. 2014;69(2):87-92.




How to Cite

Barman, G., Bujarbaruah, K., Choudhury, B. K., & Kataki, A. C. (2020). Ultrasound evaluation of biopsy proven malignant breast mass. International Journal of Research in Medical Sciences, 8(2), 706–713. https://doi.org/10.18203/2320-6012.ijrms20200261



Original Research Articles