Abstract
The present study aimed at evaluating and comparing the diagnostic performance of B-mode ultrasound (US), elastography score (ES), and strain ratio (SR) for the differentiation of breast lesions. This retrospective study enrolled 431 lesions from 417 in-hospital patients. All patients were examined with both conventional ultrasound and elastography. Two experienced radiologists reviewed ultrasound and elasticity images. The histopathologic result obtained from ultrasound-guided core biopsy or operation excisions were used as the reference standard. Pathologic examination revealed 276 malignant lesions (64%) and 155 benign lesions (36%). A cut-off point of 4.15 (area under the curve, 0.891) allowed significant differentiation of malignant and benign lesions. ROC (receiver-operating characteristic) curves showed a higher value for combination of B-mode ultrasound and elastography for the diagnosis of breast lesions. Conventional ultrasound combined elastography showed high sensitivity, specificity, and accuracy for group II lesions (10mm<lesion diameter ≤20mm). Elastography combined with conventional ultrasound show high specificity and accuracy for differentiation of benign and malignant breast lesions. Elastography is particularly important for the diagnosis of BI-RADS 4 and small breast lesions.
Highlights
Breast cancer is a common form of malignant cancer in women
Conventional ultrasound diagnostic sensitivity, specificity, and accuracy were observed to be 87.0%, 79.2%, and 81.9%, respectively; while for elastography, the diagnostic sensitivity, specificity, and accuracy were 81.9%, 83.2%, and 82.4%, respectively
Most malignant breast lesions are characterized by dense interstitial fibrosis; the cancer cells in the fibrous stroma infiltrate the lesion caused by nearby construction activity, reducing adhesion and decreasing elasticity
Summary
Breast cancer is a common form of malignant cancer in women. According to the WHO data, approximately 502,000 women world-wide die from breast cancer every year (Brenner et al, 2007; Leung et al, 2012). The incidence of breast cancer has increased in China, and has been observed even in younger generations (Jing et al, 2014). The uses of ultrasonography have expanded from differentiating between cysts and solid masses to screening of breast cancer. This technique clearly displays the layers of tissues within the breast according to the acoustic impedance, which in turn aids in recording the difference in tumor edge, shape, and other characteristics. The sonographic features of benign and malignant lesions have been shown to have a substantial overlap with each other (Jackson et al, 1995; Rahbar et al, 1999)
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