The Value of Color Doppler Ultrasound and Mammography Combined with Tumor Marker Examination in the Diagnosis of Breast Cancer

Abstract

Background: Color Doppler ultrasound, mammography and serum tumor marker examination are commonly used tests for diagnosing breast cancer, while the value of individual test is limited. This study explored the clinical significance of these tests in combination, including color Doppler ultrasound, mammography, serum tumor markers, Carbohydrate antigen 153 (CA153), Carcinoembryonic antigen (CEA), and Carbohydrate antigen 125 (CA125) for the diagnosis of breast cancer. Methods: A retrospective analysis of 80 patients diagnosed with breast cancer and 50 patients with benign breast lesions was performed. These study participants underwent color Doppler ultrasound and mammography, and their serum levels of tumor markers CA153, CEA, and CA125 were assessed using electrochemiluminescence immunoassay. Results: Color Doppler ultrasound revealed irregular morphology, unclear boundaries, burr sign, posterior echo attenuation, tiny calcifications, aspect ratio ≥1, and proportions of blood flow grades II to III in the breast cancer group. The maximum blood flow velocity (Vmax), Resistance index (RI), and Pulse index (PI) of blood flow were significantly higher in the breast cancer group compared to those in the benign control group (p < 0.01). Mammography revealed that irregular morphology, unclear boundaries, lobulation signs, and spiculated changes in the tumor, and the proportions of tiny calcifications, granular calcifications, or cast-shaped calcifications were significantly greater in the breast cancer group compared to the benign control group (p < 0.01). Furthermore, serum CA153, CEA, and CA125 levels were significantly elevated in the breast cancer group compared to the benign control group (p < 0.01). Moreover, the levels of high clinical stage, poor differentiation, distant metastasis, and the levels of Estrogen Receptor (ER)/Progesterone Receptor (PR) negative and human epidermal growth factor receptor 2 (HER2) positive group were significantly greater compared to the benign control group (p < 0.01). Additionally, the sensitivity, accuracy and each individual examination of color Doppler ultrasound and mammography in combination with serum CA153, CEA, and CA125 in diagnosing breast cancer were significantly improved (p < 0.01), which were 95.00% and 92.31%, respectively. Conclusion: The combination of ultrasound, mammography, and serum tumor markers CA153, CEA, and CA125 shows promise as a diagnostic approach for breast cancer. While individual tests have limited clinical significance, their combined use can substantially improve diagnostic sensitivity and accuracy, thereby reducing the likelihood of misdiagnosis.