Evaluation of Solid Breast Lesions by Colour Doppler Ultrasound

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Authors : Avineesh Skandan


In 1991, Judah Folkman emphasized the 'angiogenic switch' hypothesis for tumor progression. Studies have showed that angiogenesis positively correlates with the degree of metastasis, tumor recurrence and shorter survival rates, thereby demonstrating the value of angiogenesis as a prognostic cancer marker. Tumor angiogenesis is similar to physiological angiogenesis; however, latter proceeds in an uncontrolled and excessive manner giving rise to leaky and tortuous vessels that are in a constant state of inflammation. As the malignant breast mass grows, tumor cells secrete peptide growth factors, which promote angiogenesis. Angiogenesis, in turn, provides the tumor mass with nutrients essential to sustain growth. In theory, the altered hemodynamics that accompany tumor angiogenesis provide the basis for discriminating between malignant and benign masses of the breast by color Doppler sonography. Lack of smooth muscle in the arteriolar wall and absence of a normal capillary bed results in modified end-organ resistance and arteriovenous shunting.


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