Efficacy of ultrasound elastography in diagnosis of breast lesions in men

Objective. Definition of the value of ultrasound sonoelastography in diagnosis of breast lesions in men. Methods and materials. Fifty eight men with tumors and tumor-like breast lesions were included into the study: the first group included 16 men with breast carcinoma, the second - 42 patients with nodular type of gynecomastia. The diagnosis was morphologically verified in all cases. Qualitative and quantitative assessment of the elasticity of lesions was performed, including share-wave elastography and Strain Ratio. The elasticity of lesions was compared with the elasticity of normal adipose tissue of the breast. Results. Qualitative analysis of elastography revealed increased stiffness of lesions with prominent staining of various (depending on scanner options) shades of dark blue or red in 15 patients with breast carcinoma. Areas of increased rigidity were located at the periphery of malignant lesions in 11 (68.7%) of cases. Four (25%) lesions exhibited irregular staining throughout the whole mass with foci of increased rigidity. One case (6.2%) was characterized with irregular, predominantly soft staining. ARFI (Virtual Touch Tissue Quantification) revealed the velocity of share-wave within the malignant mass of 4.20±0.17 (0.51) (2.74-5.21) m/s. Strain ratio was 2.80±0.09 (0.54) (2.38-3.47) (M±m (σ) (minimum - maximum values) (n = 16). Conclusion. Use of qualitative compression elastography and share-wave elastography in a complex with standard procedures increased the accuracy of ultrasound examination in diagnosis of male breast cancer up to 93.1% with the sensitivity of 93.7% and specificity of 92.9%. Application of qualitative compression elastography in a combination with strain ratio option in addition to standard procedures increased the accuracy of ultrasound examination in diagnosis of male breast cancer up to 79.3 % with the sensitivity of 75.0% and specificity of 80.9%.