EVALUATION OF FOCAL BREAST LESIONS USING ULTRASOUND ELASTOGRAPHY

Abstract

Breast lesions pose a significant diagnostic challenge, necessitating advanced imaging techniques for accurate characterization. Ultrasound elastography, including strain and shear wave methods, offers promising diagnostic capabilities for distinguishing between benign and malignant breast lesions. Objective: This study aimed to evaluate the effectiveness of ultrasound elastography in characterizing focal breast lesions and to compare the diagnostic performance of strain and shear wave elastography techniques. Methods: A prospective observational study was conducted, enrolling 200 women aged 18 and older with focal breast lesions detected on conventional ultrasound. Participants underwent both strain and shear wave elastography. Lesion characteristics, including stiffness scores and echogenicity, were documented. Histopathological analysis was performed on biopsied lesions to confirm diagnoses. Diagnostic accuracy metrics were calculated for both elastography techniques, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results: The average age of participants was 52 ± 10 years. Most lesions were solid (70%), with an average size of 22 mm. Shear wave elastography exhibited higher stiffness scores (average 4.5) than strain elastography (average 3.2). Diagnostic accuracy for benign lesions showed a sensitivity of 85% and specificity of 90% with elastography. For malignant lesions, sensitivity was 90% and specificity was 85%. The ROC curve analysis indicated the superior performance of shear wave elastography with an AUC of 0.85 compared to 0.80 for strain elastography. Conclusion: Ultrasound elastography, particularly shear wave elastography, demonstrates high diagnostic accuracy in characterizing breast lesions, providing valuable support in clinical decision-making.