Elastography of the breast: a prospective study of 122 lesions

Objective. To evaluate elastography in the characterization of breast nodules. Material and methods. Elastography (Hitachi, 7.5- to 13-MHz probe; Ueno classification, scores 1-3 = benign, 4-5 = malignant) was evaluated in 125 subclinical lesions in 114 patients. The results were compared to those of the ACR's BI-RADS sonography categories (benign = 2 and 3, malignant = 4 and 5) and to the results of the percutaneous samples taken and/or surgery (122 lesions evaluated, 59% < 10 mm, 61 cancers, 61 benign lesions). Results. There were three technical failures (2.4%). The elastography was in agreement with histology for 101 lesions, with 13 false-negative results and eight false-positive results (sensitivity, 78.7%; specificity, 86.9%; PPV, 85.7%; NPV, 80.3%); versus agreement with the BI-RADS classification for 98 lesions with one false-negative result and 23 false-positive results (sensitivity, 98.4%; specificity, 47.5%; PPV, 65.2%; NPV, 96.7%). Conclusion. Elastography is a simple and rapid complementary method that can improve the specificity and the PPV of morphological imaging studies of breast nodules with a low level of suspicion (BI-RADS categories 3 and 4a), which should decrease the rate of unnecessary benign biopsies.