Value of adding shear wave elastography to routine breast ultrasound examination in assessment of solid breast lesions

Purpose: To assess the additional diagnostic value of share wave elastography in combination with B-mode ultrasound versus B-mode ultrasound alone in characterization of solid breast lesions. Patients and methods: prospective study included women with a single undiagnosed solid breast lesion, between May 2016 and May 2017. All patients underwent B-mode ultrasound and (SWE), and histopathology was performed on all lesions. Results: 150 women included in this study. 87 breast lesions were malignant & 63 were benign. B-mode ultrasound was performed and the lesions were categorized according to the (BI-RADS). With a sensitivity of 89.7%, specificity of 76.2%, overall accuracy of 84%. Using SWE alone based on elasticity, speed and color pattern, the cut-off values were ≥46 kPa and ≥3.25 m/s. These values demonstrated a sensitivity of 96.6%, specificity of 90.47%, and overall accuracy of 94%. The color pattern had a better sensitivity of 96.8%, specificity of 92%, and overall accuracy of 94.5%. The combination of SWE and B-mode ultrasound results using logistic regression modeling improved diagnostic performance, with an overall accuracy of 96%. Conclusion: Combined B-mode ultrasound with shear-wave elastography will improve the overall diagnostic performance for the differentiation of benign and malignant breast lesions