Value of Breast Elastography in Evaluation of Breast Masses on Screening Ultrasound

Abstract Background Breast cancer is a global health burden and a leading cause of death in females worldwide, breast cancer alone accounts for 25% of all cancer cases and 15% of all cancer death among females. Its high incidence has led to improve patient's mortality rate. Breast cancer is the most common female neoplasm (31% of tumors in females), and the second-leading cause of death among women. Objective To evaluate the additional value of Elastography as complementary to conventional US in breast masses found on screening US. Methods The study was performed prospectively between August 2022 and January 2023 at Ain Shams University hospitals at diagnostic radiology department in 30 consecutive female patients who met all the inclusion criteria with no exclusion criteria. Results A total of 30 patients were included in our study with a mean age of 39.40 years (range 17 - 79 years). On Histopathological Evaluation, 9 (30%) lesions were malignant and 21(70%) were benign. The calculated sensitivity of Semiquantitative Elastography was 100%, specificity was 95.2% and the total accuracy was 96.7%. The PPV & NPV were 90% & 100% respectively. In our study, the best cut off value for Strain Ratio to differentiate between benign and malignant breast entities was found to be at 3.6 level (AUC, 0.984). It allowed significant differentiation between benign and malignant lesions (p < 0.001). Which considering lesions with a Strain Ratio ≤ 3.6 as benign and lesions with a Strain Ratio > 3.6 as malignant. Conclusion Breast Ultrasound Elastography is a useful imaging modality resulting in increase specificity and sensitivity in diagnosing different breast lesions. Breast Elastography provides useful information about distinguishing benign and malignant lesions. Thus, consideration of lesion stiffness could increase positive predictive values and reduce unnecessary benign biopsies and render better diagnostic results.