Breast Shear Wave Elastography in Clinical Practice

Shearwave elastography (SWE) is used in the breast mainly to aid benign/malignant differentiation. Its accuracy is similar that of grayscale US but when the two are combined a very high NPV can be obtained. This means that many benign masses which previously required a biopsy to prove benignity can be diagnosed as benign without a biopsy. The stiffness of cancers also has associations with poor prognostic features such as size, histological grade and lymph node involvement. SWE has also been shown to be useful in predicting and monitoring response to neo-adjuvant chemotherapy. It has recently been shown that stiffness of breast cancer is independently associated with breast cancer mortality.