Role Of Elastography In Evaluating Breast Lesions

Abstract

BACKGROUND AND OBJECTIVES: Breast cancer is one of the most common cancers affecting women of all ages. Timely and correct diagnosis of breast lesions is of utmost significance. Equally vital is to avoid unnecessary interventions. For a better aid in diagnosing breast lesions which are confusing on ultrasonography, a new technique called Elastography was introduced. The two methods of Elastography, Strain and Shear wave velocity measurement have recently come into practise and have been included in BIRADs classification as well. Since these novel techniques are increasingly being used in recent times, our study aimed to assess its practicability and accuracy. AIMS & OBJECTIVES OF THE STUDY: 1. To assess the role of Elastography as an added imaging modality to USG B scan in differentiating benign and malignant lesions of breast. 2. To assess the advantages and disadvantages of strain and shear wave elastography. SOURCE OF DATA: The patients attending / referred to the Radiology OPD or admitted to B.L.D.E.U’s Shri B. M. Patil Medical College, Hospital and Research Centre, Vijayapur; who fulfill the inclusion criteria between November 2015 to June 2017. METHOD OF COLLECTION OF DATA: A brief history, physical examination, ultrasonographic and elastographic evaluation will be performed on all patients who fulfill the inclusion criteria who are attending / referred to the Radiology department or admitted in BLDEU’S Shri B M Patil xviii Medical college hospital and research center, Vijayapur between November 2015 to June 2017. RESULTS: 64% of our cases were benign and 36% malignant.Common benign lesions were fibroadenomas and cysts whereas most malignant lesions were invasive/infiltrating ductal carcinomas. Sensitivity of ES and specificity of SR was better in our study. Both strain ratio and shear wave elastography showed a statistically significant difference between benign and malignant lesions. The sensitivity and specificity of shear-wave and strain elastography were different according to lesion histologic profile, tumor grade, and breast thickness. INTERPRETATION: USG is a good modality for breast lesion identification but has a limited predicting malignancy. The diagnostic performance of shear-wave and strain elastography was similar. Breast cancer screening plays a very important role in early cancer detection and helps in good prognosis. Elastography is not a method that can replace conventional breast ultrasound for detecting breast cancer; however it may be an adjunct to conventional ultrasound by increasing its diagnostic capacity.