Correlation among Intratumoral Blood Flow in Breast Cancer, Clinicopathological Findings and Nottingham Prognostic Index

Background: The purpose of this study was to evaluate the correlation among intratumoral blood flow as assessed by color Doppler ultrasonography, clinicopathological findings and the Nottingham Prognostic Index (NPI). Methods: Twenty-seven patients with breast cancer were examined. All patients received surgical treatment. Color Doppler ultrasonography was performed prior to surgery to detect arterial blood flow signals within the tumors. The lowest resistance index (RI) was recorded. Formalin-fixed, paraffin-embedded slides were reviewed by senior pathologists to evaluate the size of tumor, histological size, lymph node status and histological grade. Estrogen and progesterone receptor levels were measured by enzyme immunoassay. The Nottingham Prognostic Index was calculated using the equation NPI = 0.2 x tumor size (cm) + grade (I-III) + lymph node score (1-3). Results: The lowest RI correlated well with NPI and histological grade (grade II:III = RI 1.037: 0.816, P = 0.0035). Regression analysis revealed a linear relationship between the lowest RI and NPI (correlation coefficient = 0.475; P= 0.0153). Conclusions: Intratumoral blood flow analysis assessed by color Doppler ultrasonography correlates well with histological grade and NPI. Preoperative assessment using color Doppler ultrasonography provides useful information and may contribute to the determination of prognosis.