Effectiveness of sonoelastography in differentiation of malignant and benign breast lesions

Mammography and ultrasonography is the gold standard examination for scanning and diagnosis of breast cancer. However, these examinations have not reached the ideal specificity and sensitivity values and so the redundant invasive procedures are still continued to be problematic. In this study we aimed to evaluate the effectiveness of ultrasonic elastography in differential diagnosis of malign and benign breast lesions. In this study we enrolled 81 patients (80 female, 1 male) breast lesions detected by B-mode ultrasonography. Colored coded maps obtained by elastography. Color scale of signals obtained before and after compressions was divided into 5 scores according to Tsukuba score. Strain ratio values defined as the elasticity ratio between the peripheral and inspected tissue were calculated in all lesions. Both elasticity scores and strain ratio measurements were compared with histopathology results. The mean age of the patients were 51.3±13.1 years and the mean size of the lesions were 16.3±11.9 mm. Of the lesions 38 were malign and 43 were benign. Strain ratio values were statistically significantly different between benign and malign lesions. The mean strain ratio values for benign and malign lesions were 1.8±0.9 and 4.3±1.5, respectively. Only one of 43 histopathologically benign patients had 5 elastrography score while seven had 4 and twenty had 5 elastrography score among 38 histopathologically malign patients). Sensitivity, specificity and cut-off values were 78.9% , 90.7% and 2.84, respectively. According to strain ratio cut-off level, 88.2% of malign suspected patients were confirmed as malign and 82.9% of benign suspected patients were confirmed as benign. In conclusion ultrasonic elastography seems to be a practical and alternative technique to distinguish the benign and malign breast lesions and decrease the number of unnecessary biopsies.