Quantitative elastography in differentiating benign and malignant breast lesions

The purpose of this study was to evaluate the effectiveness of quantitative elastography in differentiating benign and malignant breast lesions that were detected by B- mode ultrasonography, to compare shear wave velocities of benign and malignant lesions, and to determine cut- off values differentiating malignant lesions from benign ones. In this prospective study we enrolled 254 breast lesions of 240 patients (237 female, 3 male) detected by B-mode ultrasonography, and underwent biopsy in our department. Shear wave elastography was performed to all lesions before biopsies. The mean age of the patients were 44.7±13.2 years. The patients who had radiotherapy or chemotherapy previously were not included. Elastography examinations were performed by one of the two radiologists specialising in breast radiology. The mean and median shear wave velocities, and standard deviation values were measured in meters/second. Both mean and median shear wave velocities were compared with histopathology results. Sensitivity, specificity, and the area under the curve were obtained by using a receiver operating characteristic curve analysis. The mean age of the patients, lesion size, mean and median shear wave velocities were significantly different between benign and malignant groups. The mean shear wave velocity of benign and malignant lesions were 3.59±1.2 m/s and 5.59±1.9 m/s, respectively. The cut- off value for the mean shear wave velocity was 4.08 m/s (71.6% sensitivity and 69.6% specificity) to differentiate malignant lesions from benign ones. In conclusion, quantitative elastography is an effective and complementary method making a significant contribution in differentiating benign and malignant lesions. In this respect, we believe that clinical usage of shear wave elastography should be generalized.