Multicenter Prospective Study of Color Doppler Ultrasound for Breast Masses: Utility of Our Color Doppler Method

Takanori Watanabe, Setsuko Kaoku, Takuhiro Yamaguchi, Ayumi Izumori, Sachiyo Konno, Toshitaka Okuno, Hiroko Tsunoda, Kanako Ban, Koichi Hirokaga, Terumasa Sawada, Toshikazu Ito, Shuichi Nakatani, Hidemitsu Yasuda, Masahiko Tsuruoka, Ei Ueno, Eriko Tohno, Takeshi Umemoto, Takako Shirakawa

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)


The use of color Doppler ultrasound (CD)for distinguishing between benign and malignant breast lesions remains controversial. This study (JABTS BC-04 study)was aimed at confirming the usefulness of our CD diagnostic criteria. We evaluated ultrasound images of 1408 solid breast masses from 16 institutions in Japan (malignant: 839, benign: 569). Multivariate analysis indicated that vascularity (amount of blood flow), vascular flow pattern (“surrounding marginal flow” or “penetrating flow”)and the incident angle of penetrating flow were significant findings for distinguishing between benign and malignant lesions. However, the sensitivity and specificity of B-mode alone did not improve significantly with CD addition (97.6% → 97.9%, 38.3% → 41.5%, respectively). We explored the causes of these negative results and found that age should have been considered when evaluating vascularity. Simulation experiments suggested that specificity is significantly improved when age is taken into consideration (38.3% → 46.0%, p < 0.001)and we thereby improved our diagnostic criteria.

Original languageEnglish
Pages (from-to)1367-1379
Number of pages13
JournalUltrasound in Medicine and Biology
Issue number6
Publication statusPublished - 2019 Jun


  • Breast cancer
  • Color Doppler
  • Diagnostic criteria
  • Elastography
  • Multicenter study
  • Ultrasound


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