ABSTRACT

In this study, the contribution of ultrasound (US) elastography in the characterization of solid breast masses was investigated.

Seventy-five patients (1 male and 74 female, aged between 19 and 80 years) were enrolled. A total of 75 solid breast lesions, for which a biopsy was planned, were evaluated using B-mode US and US elastography during the same session. Using B-mode US, the lesions were classified according to the Breast Imaging Reporting and Data System (BI-RADS); Tsukuba elasticity score was determined and strain ratio was calculated for all lesions. Subsequently, a core biopsy of the lesions was performed. BI-RADS results, Tsukuba elasticity scores, and strain ratio were compared with the histopathological results.

Of 75 lesions, 47 were benign (62.66%) and 28 were malignant (37.33%). According to the Tsukuba scoring method, the mean score of benign and malignant lesions was 2.31 and 3.96, respectively. The mean strain ratio was calculated to be 4.97±2.94 (0.96–13.20) for malignant lesions and 2.27±1.41 (0.5–5.84) for benign lesions. In statistical analysis, the mean strain ratio of the malignant lesions was significantly higher than that of the benign lesions (p<0.05). BI-RADS classification had the highest sensitivity (89.3%), and the Tsukuba scoring method had the highest specificity (93.6%). Elastographic assessment altered the result in 6 of 8 patients (75%) that B-mode US was missed.

The combination of B-mode US and US elastography can significantly improve the accuracy of diagnosis and characterization of breast lesions, thereby reducing the unnecessary biopsy rate.

Keywords: BI-RADS, elastography, solid breast lesions, ultrasound