Abstract
ObjectiveTo evaluate the diagnostic performance of shear-wave elastography (SWE) for the differential diagnosis of breast papillary lesions.MethodsThis study was an institutional review board-approved retrospective study, with a waiver of informed consent. A total of 79 breast papillary lesions in 71 consecutive women underwent ultrasound and SWE prior to biopsy. Ultrasound features and quantitative SWE parameters were recorded for each lesion. All lesions were surgically excised or excised using an ultrasound-guided vacuum-assisted method. The diagnostic performances of the quantitative SWE parameters were compared using the area under the receiver operating characteristic curve (AUC).ResultsOf the 79 lesions, six (7.6%) were malignant and 12 (15.2%) were atypical. Orientation, margin, and the final BI-RADS ultrasound assessments were significantly different for the papillary lesions (p < 0.05). All qualitative SWE parameters were significantly different (p < 0.05). The AUC values for SWE parameters of benign and atypical or malignant papillary lesions ranged from 0.707 to 0.757 (sensitivity, 44.4–94.4%; specificity, 42.6–88.5%). The maximum elasticity and the mean elasticity showed the highest AUC (0.757) to differentiate papillary lesions.ConclusionSWE provides additional information for the differential diagnosis of breast papillary lesions. Quantitative SWE features were helpful to differentiate breast papillary lesions.
Highlights
Papillary lesions of the breast have a wide spectrum, including benign papilloma, atypical papilloma, and papillary carcinoma [1]
Orientation, margin, and the final BI-RADS ultrasound assessments were significantly different for the papillary lesions (p < 0.05)
Ko et al [5] suggested that well-selected benign papilloma can be treated with US-guided vacuum-assisted excision (VAE) rather than surgical excision
Summary
Papillary lesions of the breast have a wide spectrum, including benign papilloma, atypical papilloma, and papillary carcinoma [1]. Previous studies [2, 3] have reported that surgical excision is recommended for an accurate diagnosis of benign papilloma diagnosed using ultrasound (US)-guided CNB. Some studies have reported that US-guided vacuum-assisted excision (VAE) is accurate and could be an alternative to surgery for benign papillary lesions [4,5,6,7]. Ko et al [5] suggested that well-selected benign papilloma (category 3 or 4A papillary lesions < 1.5 cm) can be treated with US-guided VAE rather than surgical excision. Management of breast papillary lesions is controversial, the current trend is to use US-guided VAE for well-selected benign papillary lesions diagnosed by USguided CNB [4,5,6,7]. Sub-analysis of breast papillary lesions is essential for managing patients
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