Diagnostic performances of sonoelastography in non-palpable malignant breast lesions

The aim of the investigation was to evaluate the diagnostic possibilities of sonoelastography (SE) to diagnose non-palpable malignant breast lesions, with pathomorphological correlation. Also the aim was to determine the accuracy of using a comparison of the strain of an adjacent fat area to strain of the lesion – Strain Ratio (SR). 193 lesions (133 benign, 60 malignant) were analyzed with the Hitachi Hi Vision 900 and Hitachi Hi Vision Preirus and a linear-array transduser of 7,5–13 MHz. The elastography data were compared with histopathologic findings (fine needle aspiration, core or surgical biopsy). Elasticity images were assigned an elasticity score according to the degree and distribution of strain induced by light compression (five-point color scale: 1–3 – benign, 4,5 – malignant). SR is obtained by dividing strain of subcutaneous fatty tissues with that of the lesion. Statistical analysis included sensitivity, specificity, accuracy, positive predictive value, negative predictive value. The SE was in agreement with histology for 162 lesions, sensitivity 80%, specificity 86%, accuracy 84%). SR shows low value in non-palpable benign lesions and high value in non-palpable malignant lesions. Using a cut-off of 2,2, SR achieved high percentage in specificity and sensitivity: 81% and 79% respectively. A combination of SE and sonography and mammography had the best results in detecting non-palpable breast cancer. SE is a promising technique for evaluating breast lesions.