HARUN ARSLAN, Zülküf AKDEMİR, Alpaslan YAVUZ, Necat İSLAMOĞLU, SEBAHATTİN ÇELİK, MESUT ÖZGÖKÇE, ABDUSSAMET BATUR, HÜSEYİN AKDENİZ, Harun Egemen TOLUNAY

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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