Ultrasound Elastography May Better Characterize BI-RADS 3 and BI-RADS 4A Lesions to Decrease False-Positive Breast Biopsy Rates and Enable Earlier Detection of Breast Cancer.

Abstract

Although ultrasound elastography has been studied for more than a decade, this technology is not yet widely used in breast imaging [ 1 Barr R.G. Breast elastography: how to perform and integrate into a “best-practice” patient treatment algorithm. J Ultrasound Med. 2020; 39: 7-17 Crossref PubMed Scopus (19) Google Scholar , 2 Barr R.G. Future of breast elastography. Ultrasonography. 2019; 38: 93-105 Crossref PubMed Google Scholar ]. Existing publications that support ultrasound elastography as an adjunct to B-mode ultrasound are mostly small, retrospective, single-institution studies that lack the scientific momentum of a large multicenter prospective trial or meta-analysis to impel ultrasound elastography into clinical use. The accompanying systemic review and meta-analysis on ultrasound shear wave elastography (SWE) for breast imaging by Pillai et al provides some of the strongest evidence to date that SWE may be ready for clinical use as a noninvasive assessment of tissue stiffness [ 3 Pillai A. Voruganti T. Barr R. Langdon J. Diagnostic accuracy of 2D shear wave elastography for breast lesion characterization in women: a systematic review and meta-analysis. J Am Coll Radiol. 2022; 19: 625-634 Abstract Full Text Full Text PDF Scopus (1) Google Scholar ]. Specifically, this meta-analysis suggests that SWE has significant discriminative power to characterize certain breast lesions according to the ACR BI-RADS as probably benign (BI-RADS 3) or suspicious (BI-RADS 4).