Publication:

Sonomammographic and sonoelastographic evaluation of benign and malignant breast lesions and its correlation with fine needle aspiration cytology

Background Breast cancer affects 25.8% of women worldwide. Mammography and ultrasound have sensitivity, but invasive breast biopsies and aggressive biopsies are essential. Sonoelastography is a non-invasive imaging method that can measure tissue stiffness related to different pathologic conditions, such as cancer. Objective is to assess the diagnostic accuracy of sonomammography and sonoelastography in diagnosing breast lesions as benign or malignant in correlation with fine needle aspiration cytology (FNAC) as gold standard.

Methods This study was conducted on 52 female patients with breast mass and sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), kappa and p value of conventional gray scale ultrasound and ultrasonography (USG) elastography were calculated and compared with that of FNAC. Ultrasound was performed using grayscale and elastography mode on GE LOGIQ P9 ultrasound equipment with a 7-12 MHz linear-array transducer. All cases with breast lesions identified on ultrasound elastography underwent FNAC.

Results The sensitivity, specificity, PPV, NPV of sonoelastography were 78.5, 94.7, 84.6, 92.3 with kappa 0.75 and p value <0.0001. Similarly, sensitivity and specificity for strain ratio were 85.7 and 97.4, and that for size ratio were 85.7 and 100 respectively. These results are comparable to or better than results for conventional ultrasound.

Conclusions Breast elastography makes it easier to classify BIRADS 3 category lesions which are benign but still confused as malignant on conventional USG. BIRADS category 3 and 4 lesions with benign findings on sonoelastography can be downgraded to category 2 and 3 respectively thus reducing the number of false positive malignancy cases and biopsy.