The Role of Ultrasonography and Elastography in Differentiating Benign From Malignant Breast Masses With Pathologic Correlation

Abstract

Objective: Elastography has the potential in differentiating benign from malignant masses. The objectives of the study were to evaluate morphology of the breast masses with routine ultrasonography and elastography, to assess the role of elastography and conventional B-mode ultrasonography in differentiating benign from malignant breast masses and to correlate elastography and B-mode ultrasonography results with pathologic findings. Materials and Methods: This prospective observational study was conducted over a period of 18 months from January 2018 to June 2019 on 86 patients with 101 clinically palpable breast lumps who underwent B-mode ultrasonography and elastography of the breast. Baseline data, sonographic features, a modified color score, and mean strain ratio were recorded and compared with final diagnosis. Results: Sonography showed a sensitivity of 89.8%; specificity of 96.15%; positive predictive value (PPV) and negative predictive value (NPV) of 95.65% and 90.91%, respectively; and overall diagnostic accuracy of 93.07%. New modified dual color score showed sensitivity of 97.8%, specificity of 87.0%, PPV of 86.79%, and NPV of 87.08% with a diagnostic accuracy of 92.08%. The risk of missing a malignant case with the new modified dual color score was 2.1%. Mean strain ratio showed sensitivity of 100%; specificity of 98.11%; PPV and NPV of 97.96% and 100%, respectively; and diagnostic accuracy of 99.01%. Conclusion: This study demonstrates the promise of elastography in identifying possible breast malignancies, thus preventing unnecessary invasive procedures.