The Role of Elastography in Differentiating Benign and Malignant Breast Lesions

Background: The differential diagnosis of benign and malignant breast lesions is a significant challenge in radiology. Traditional imaging modalities such as ultrasonography (USG) and mammography, despite their widespread use, have limitations in accurately differentiating tissues. Elastography, a modern ultrasound imaging technique, enables the assessment of biomechanical properties of tissues, such as hardness and elasticity, offering new possibilities in breast cancer diagnosis. Objective: The aim of this study is to review the literature on the use of elastography in the diagnosis of breast lesions, with a focus on its effectiveness in differentiating benign and malignant lesions. Different elastographic techniques, their diagnostic parameters and their benefits and limitations compared to traditional imaging modalities are discussed. Methods: The analysis was based on the available scientific literature published in the last 20 years, searching databases such as PubMed, Scopus and Web of Science. Studies evaluating the effectiveness of elastography (strain and shear-wave) in breast cancer diagnosis and its application in clinical practice were included. Results and conclusions: Elastography demonstrates high diagnostic efficacy, achieving sensitivity and specificity comparable to or superior to traditional ultrasound. Due to its ability to non-invasively assess tissue hardness, elastography can reduce the number of unnecessary biopsies. However, the literature review indicates some limitations, such as operator dependence and differences in results obtained with different devices. Further studies, especially multi-centre studies, are needed to standardise diagnostic standards.