Diagnostic value of strain elastography in differentiation of benign than malignant breast masses and its correlation with findings from histopathology

Abstract

Breast cancer is the most common malignancy in the United States and is the second leading cause of cancer death. Strain elastography (SE) provides a qualitative relative measurement for tissue stiffness in comparison to the adjacent presumably normal tissue, because the quantitative stress force at the site of straining cannot be measured in this method. The aim of this study was To assess the differences in Doppler and strain elastography (SE) in benign and malignant breast masses. Materials and Methods: In this retrospective study, women with breast masses of BI-RADS of ≥ 3 underwent SE. The ratio of elasticity in the reference fibro-glandular tissue in contrast to 3 regions of the lesions was estimated. All BI-RADS ≥ 4 and BI-RADS 3 lesions with ≥2 vascular flows were recommended to undergo biopsy. Doppler and SE characteristics were compared between the malignant and benign lesions. Results: Of all 112 lesions, 50 were malignant and 62 were benign. The malignant group had a higher ratio of elasticity in the fibro-glandular tissue/mass in the peripheral (p-value 0.019) and marginal (p-value 0.038) zones. In Doppler, the malignant group had a significantly higher resistance index (RI) (p-value 0.004) and peak systolic velocity (p-value 0.048). In receiver operator characteristic (ROC) curve analysis, RI had a significant diagnostic value with an area under the curve of 0.757.