The Role of Ultrasographic Elastography in the Differential Diagnosis of Breast Masses and Its Contribution to Classical Ultrasonographic Evaluation

Objective: The aim of this study was to understand the role of ultrasonographic elastography method in the differentiation of breast masses and to assess its contribution to classic ultrasonographic evaluation. Materials and Methods: In this retrospective study, 76 breast masses in 76 patients were firstly evaluated by conventional ultrasonography (U.S.) and scored according to breast imaging report and data systems (BIRADS) and then evaluated with the Elastographic method during the same session between January and December 2013 in our hospital's Radiology Department. Findings were compared with pathological results. In statistical evaluation of the data, independent sample t tests were used for variables between groups. Results: The mean strain ratio of benign masses was 2.48 +/- 1.605 and strain score was 2.307 +/- 1.327. The mean strain ratio of malignant masses was 5.546 +/- 1.434 and strain score was 4.458 +/- 0.721. The most frequent benign masses were fibroadenoma and fibrocystic lesions. The most common malignant lesion was invasive ductal carcinoma. When the cut-off value for strain ratio was accepted as 4.009 in receiver operating curve (ROC) analysis for the differential diagnosis of malignant breast masses, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated as 83.8%, 76.9%, 62.3%, and 90.7%, respectively. When the limit value of strain patterns was accepted as scores 4 and 5, the sensitivity, specificity, PPV, and NPV were calculated as 42.7%, 94.2%, 77.2%, and 78%, respectively. When conventional ultrasonography (U. S.) findings were considered together with the elastographic strain ratios the sensitivity, specificity, PPV and NPV were 87.5%, 71.1%, 58.3% and 92.5%, respectively. Conclusion: 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 power.