Contribution of sonoelastography in the differentiation of benign and malignant breast masses: A comparative analysis on sonographic birads classification

In this study, we aimed to investigate the effectivity of ultrasonographic elastography in the differentiation of benign and malignant lesions detected on B-mode ultrasonography. The retrospective study included 133 consecutive patients who underwent B-mode USG followed by elastography between January 2013 and December 2015. The lesions were scored by using B-mode USG with breast imaging-report and data systems (BIRADS) and then sonoelastographic color-coded maps were obtained by elastography in a single session. Sonoelastographic scoring was achieved with a 5-point scoring system. Elasticity scores and strain ratio (SR) values were compared with histopathological findings. The 133 patients included 132 (99.2%) women and 1 (0.8%) man. Mean age was 40.45±14.8 years. The lesions were mostly localized in the left breast (n=70, 52.3% vs. n=63, 47.7%). Depending on the pathological findings, 94 (71.2%) lesions were classified as benign and 39 (28.8%) as malignant. Mean SR value was 4.419±1.43, with 5.5 in malignant lesions and 4.3 in benign lesions. At the cut-off value of 4.95 for SR, the sensitivity and specificity of USG in elastographic examination were 81.6% and 78.7%, respectively. A significant correlation was found between the SR value and the BIRADS score calculated on USG (rho=0.86; two-tailed; p<0.001). Similarly, a significant correlation was found between the SR value and the elasticity score (rho=0.88; two-tailed; p<0.001). In conclusion, the use of sonoelastographic examination following the USG examination with B-mode ultrasonography can be a complementary diagnostic method that increases the specificity of USG. Moreover, it can also reduce unnecessary biopsies in lesions with suspicious malignancy.

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