Contribution of Sonoelastography to Diagnosis in Distinguishing Benign and Malignant Breast Masses

Objectives The purpose of this study was to investigate the contribution of strain index measurements and a 5-point scoring method to diagnostic accuracy in differential diagnosis of benign and malignant solid breast masses and to compare the diagnostic performances of both methods. Methods Eighty female patients were included in this study. Before biopsy, all patients underwent ultrasound (US) and sonoelastographic examinations. The elastographic images of lesions were assessed according to the 5-point scoring method, and then elasticity scores were determined. Strain values of the masses and subcutaneous adipose tissue were measured. The diagnostic efficacies of B-mode US, sonoelastographic 5-point scoring, and strain index methods were compared with histopathologic findings. Results The mean age of the patients +/- SD was 42 +/- 13 years (range, 14-81 years). In histopathologic evaluations, 59 (74%) lesions were diagnosed as benign, and 21 (26%) were diagnosed as malignant. The mean strain index values were 10.45 +/- 7.04 (range, 3.4-25.1) in malignant lesions and 2.88 +/- 2.5 (range, 0.5-19.81) in benign lesions. The mean strain index for malignant lesions was significantly higher than that for benign lesions (P < .05). The highest sensitivity was found for B-mode US, and the highest specificity was found for the strain index. The diagnostic performance of the strain index was higher than that of the 5-point scoring method. Conclusions The addition of a sonoelastographic examination to B-mode US prevents unnecessary biopsies. The strain index was found to be superior to the 5-point scoring method to a limited extent.