Ultrasound elastography improves differentiation between benign and malignant breast lumps using B-mode ultrasound and color Doppler

AbstractObjectivesTo evaluate diagnostic yield of mammography, B-mode ultrasound (US), ultrasound elastography (UE) and color Doppler used alone or in combination for differentiating breast lesions.Patients and methodsSixty women presented by breast lump underwent mammographic examination, B-mode US, color Doppler assessment and UE. The result of histopathological examination of excisional biopsy was used as gold standard for comparison of results.ResultsMammography defined 36 patients had dense glandular breast and 24 patients had fatty parenchyma. Eleven patients had dense glandular parenchyma and 7 of those had fatty parenchyma had malignant lesions. Mean resistive index for malignant lesions was significantly higher than benign lesions. The mean strain ratio was significantly higher for malignant. Combined use of US and UE provided better diagnostic yield than US and Doppler, while combined use of US, UE and Doppler improved the diagnostic yield with high sensitivity and specificity and NPV of 95%. ROC curve analysis assured the high diagnostic yield of combination of US, UE and Doppler.ConclusionCombined use of B-mode US, UE and color Doppler achieved NPV of 95% thus allowed sparing of unnecessary invasive diagnostic procedures. UE as a sole diagnostic test has high sensitivity and specificity. Mammography could be used as screening test for its high sensitivity