Diagnostic value of shear wave elastography in non-mass lesions of the breast

Purpose: In this study, we aimed to investigate the diagnostic performance of the quantitative shear wave elastography method in distinguishing benign and malignant breast non-mass lesions. Materials and Methods: In this prospective study, 61 lesions belonging to 61 female patients (age range 30-85) who were detected to have non-mass lesions in the breast between June 2021 and April 2023 and were categorized as BIRADS 4,5 were included. After the lesions were examined with B-mode US, Maximum elasticity (Emax) and Mean elasticity (Emean) values, which are quantitative elasticity parameters, were measured with the SWE technique. After the measurement, tru-cut biopsy was performed on the lesions. Quantitative SWE measurements and histopathological results were compared statistically. Results: According to histopathological results, 34 lesions(55.8%) were diagnosed as benign and 27 lesions (44.2%) were diagnosed as malignant. The median Emax value in benign and malignant lesions was 84.75 kPa and 178.60 kPa, respectively. The median Emean value in benign and malignant lesions was 66.20 kPa and 131.50 kPa, respectively. Emax and Emean values of malignant lesions were found to be statistically significantly higher than benign lesions (p<0.001). In the ROC curve analysis for the Emax value, the area under the curve was calculated as 0.862 and the cut-off value was determined as 130 kPa. According to this value, sensitivity was found to be 85.2%, specificity was 82.4%, positive predictive value was 79.3% and negative predictive value was 87.5%.In the ROC curve analysis for the Emean value, the area under the curve was calculated as 0.855 and the cut-off value was determined as 89,80 kPa. According to this value, sensitivity was found to be 81,5%, specificity was 79,4%, positive predictive value was 75,8% and negative predictive value was 84,3%. Conclusion: It was concluded that the addition of Shear-Wave Elastography technique to B-mode US examination in non-mass lesions of the breast increased the diagnostic performance in distinguishing between benign and malignant lesions. Key words: Breast cancer, Non-mass lesion, Shear-wave Elastograph