| Object: To provide more accurate parameters in the early diagnose of breast cancer, the comparison of the different features of benign and malignant breast tumors was made by ultrasound techniques. The characteristics of 2-Dimensional image, hemodynamic parameters and patterns of vascular distribution were investigated, and the biopsy under ultrasound guidance was also applied in some cases. Methods: One hundred and twenty five breast lesions were studied, including 33 patients with breast carcinoma, 92 patients with benign mass in breast. ATL HDI 5000 (USA) color Doppler sonography system and the ultra wide range linear-array transducer with frequency 5-12 MHz was used in this study. All subjects lay on their back and were observed with direct contact. The breast lesions were first scanned by 2-dimensional sonography examination. The shape, edge, size, membrane, internal and rear echo and lateral shadow of the lesions were carefully observed. Attention was also paid to detect the existence of calcification and enlarged axillary lymph node. The longitudinal - transverse axis ratio was calculated. Then the lesions were further observed with Color Doppler Flow Imaging (CDFI). The number, shape and distribution of theinternal and peripheral vessels of the lesion were tested, and the area with the richest blood flow was chosen to calculate the number of the vessel and make semi-quantitative classification of blood flow. The most prominent internal and peripheral vessels of the lesion were examined with PWD to judge the quality of the signal, measure the PSV and RI. The measurement was repeated three times and the average value was applied. The lesion was further examined with CDE to observe the internal and peripheral blood flow of the lesion. Then 3D-CPA was used to detect the characteristic of blood flow of the lesion in a 3 dimensional way. In 13 cases, the breast biopsy was performed under the guidance of ultrasound. All cases had final diagnoses which were confirmed by pathology. SPSS 10.0 software was used to analysis data. The chi-squire test and t test were performed.Result: There was significant difference between benign and malignant lesions regarding the appearance of the lesion, including the shape, edge, membrane, internal and rear echo and lateral shadow, the longitudinal -transverse axis ratio, and the existence of calcification and enlarged axillary lymph nodes. Since the axillary lymph node was enlarged in 48% breast cancer patients while none of the benign lesion had enlarged lymph node, it was an important indirect sign for differential diagnosis. Only 5% benign lesions were showed calcification, but the malignant tumor has much higher prevalence-48.5%. The calcification was usually coarsearch in shape, in contrast to pin-point clustered calcification of malignancy. If the longitudinal - transverse axis ratio 0.7 was set as a borderline in diagnosis of breast cancer, its sensitivity was 66.7%, and the specificity 77.2%. As to CDFI, the blood flow signal was richer in malignancy than that in benign lesion. 27 out of 33 malignant tumor showed grade II -III blood flow. The blood supply was few in benign lesion, and 62 out of 92 benign lesions did not show blood flow and only 3 cases showed grade III blood flow. There was significant difference in the extent of blood flow between the malignancy and benignancy. When comparing the vessel morphology, 79%(26/33) breast cancer demonstrated penetrating vessel, while 42% benign lesions had no vessel and only 11 out of 92 benign lesions had penetrating vessel. 3D CPA showed that the vessel in benign lesion had fewer branch, smaller diameter and more regular shape than the vessel in malignant tumor. The hemodynamic parameters PSV and RI were significantly higher in breast cancer than that in benign lesions.Breast biopsy was performed in 13 cases, including one case of cancer, 4 cases of breast fibroadenoma, 1 case of abscess, and 7 cases of hyperplasia. The success rate of biopsy was 100%. 7 cases of hyperplasia were followed up for 4-6 month...
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