The role of combined strain and shear-wave (ARFI) sonoelastography methods indiagnosis and birads classification of the solid lesions of the breast, histopathologyc correlation with molecular subgroups of breast cancer

Objective The purpose is to evaluate the diagnostic performances of sonoelastography methods in the differentiation of malignant and benign breast lesions and to determine whether the correlation with the results of breast cancer molecular subgroups. Material and method A total of 55 patients whose ages ranged from 27-86 and had a breast lesion after mammography and breast USM examination were included in the study. Color scale of signals obtained before and after compressions was divided into 5 scores according to Tsukuba score. E-ratio values defined as the elasticity ratio between the peripheral and inspected tissue were calculated in all lesions. During shearwave sonoelastography evaluate speed measurement without compression to the lesion. All measurements were compared with histopathologic results and molecular subgroups. Results The mean E-index values were 3.9 ± 0.8 in malignant lesions, 2.6 ± 1.2 in benign lesions and E- ratio values were 5.4 ± 3.2 in malignant lesions and 3.0 ± 2.5 in benign lesions. Mean values of shearwave velocity measurements of the lesions were 3.3 ± 0.8 in malignant lesions and 2.1 ± 1.5 in benign lesions. Results were evaluated with Independent T test and statistically significant differences were found (p<0.05). When the E-index threshold value was determined as 2.8 by ROC analysis, it is 78.8%, specificity is 85.9%, E-ratio threshold value is 3.45, sensitivity is 78.5%, specificity is 83.0%, SWE rate value is 2,4 m/s sensitivity is 73.7% and specificity is 82.8%. A negative correlation was found between the percentage of ER receptor and SWE measurement. Conclusion Strain and shearwave sonoelastography are a complementary technique to differentiate breast lesions from benign and malignant and may reduce the need for biopsy for these lesions. Key Words: ARFİ, breast cancer, shear-wave elastography, sonoelastography, strain elastography,