Muddassir Rashid MBBS, Presenter: Nothing to Disclose

Sajjad A Dar MBBS, MD, Abstract Co-Author: Nothing to Disclose

Sanna Kirmani MBBS, , Abstract Co-Author: Nothing to Disclose

To determine the role of real time ultrasound elastography in differentiating benign from malignant breast lesions.

The prospective study was carried out on 125 patients who had breast lesions. The study was done using Acuson 2000 (Siemens Medical) ultrasound machine. Tsukuba Elastography Scoring as proposed by Itoh A et al was used to score the elastograms. The histology of all the nodules was established with fine needle aspiration cytology, core biopsy or excision biopsy. The elasticity scores were correlated with the histology and the accuracy of diagnosis of the breast nodules calculated. Mean elastography scores of both the groups were calculated and compared using students t-test. The sensitivity, specificity and accuracy rates were calculated based on histology as the gold standard.

Our study included 125 patients of age-groups 30-78 years having breast lesions (total of 134 lesions). Of which 81 lesions were benign and 44 lesions were malignant. Among the benign lesions fibroadenoma was the most common benign lesion (40, 49.3%) followed by fibrocystic change( 26, 32.1%) and duct papilloma ( 15, 18.5%). Of the malignant nodules, 30 were due to infiltrative ductal carcinoma (68.1%), 8 were lobular carcinomas (18.18%), 3 ductal carcinoma in situ (6.81%) and 3 others. The elasticity score was lowest in benign and highest in malignant nodules. The median elasticity score for benign nodules was 2, while that for malignant nodules was 5. The percentage of lesions with an elasticity score of 1 or 2 that were benign was 99.2 (95% CI 98.5–99.7), while 63.5% of lesions with an elasticity score of 3 were benign (95% CI 53.8–73.4). 82.7% of lesions with a score of 4 or 5 were malignant (95% CI 75.8–89.9). Therefore, to calculate the sensitivity and specificity of elastography, lesions with elasticity scores 1–3 were classified as benign, while those with scores of 4 or 5 were classified as malignant. Elastography had a sensitivity of 74.2% and specificity of 99.2%. The overall accuracy rate for elastography it was 94.2%

Realtime ultrasound elastography is user-friendly with a high accuracy rate, thereby improving B mode ultrasound assessment.

Elastography along with sonographic assessment of breast lesions can help in differentiation of benign from malignant breast lesions though tissue diagnosis is still considered to be the gold stadard

Rashid, M, Dar, S, Kirmani, S, Ultrasound Elastography in Differentiating Benign and Malignant Breast Lesions.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8006889.html Accessed April 9, 2025