Sonography And Sonographic Analysis

ROLE OF SONOELASTOGRAPHY IN EVALUATION OF BREAST LESIONS

Aims:

To evaluate the efficacy of ultrasound elastography when used as an adjunct to mammography and sonography in the evaluation of breast lesions.

Settings and Design:

This was a prospective observational study done over a period of 18 months.

Sixty patients detected to have a mass on screening mammography or referred for evaluation of a palpable breast mass to the imaging department of a tertiary care hospital were included in the study.

Methods and Materials:

The mammography was performed on a BET FLAT SE Mammography machine and sonography and elastography were performed on a Philips IU22 system.

Written and informed consent were obtained. The patient’s clinical history and

The sensitivity and specificity of mammography and sonography was compared with that of mammography and sono-elastography

Statistical analysis was performed for all variables and sensitivity, specificity, positive and negative predictive values were calculated.

Results:

Of the 60 lesions 28 appeared benign and 32 appeared malignant on mammography and ultrasonography. Elastography revealed 37 of the 60 lesions to be benign and 23 to be malignant. Histopathology confirmed 36 of the lesions to be benign and 24 to be malignant. The commonly seen benign lesions were chronic abscesses and cystic changes of the breast. The most common malignancy detected was invasive ductal carcinoma and ductal carcinoma in situ.

Conclusions:

We found that elastography using a cut-off value of 2.5 for the strain ratio had a higher specificity, positive and negative predictive value when used as an adjunct to sonomammography,

Key-words: Elastography, breast lesions, strain elastography, sonomammography, FNAC.

Few benign lesions such as a fibroadenoma and a chronic abscess had a higher strain ratio and appeared to be hard on elastography. These patients were false positive on sonoelastography.

Discussion:

Maximum number of patients with palpable and non-palpable breast lumps were in the age group of 40-50 years, followed by those between 60-70 years (Table 1). Mean age was seen to be 50.6 in the study. (Table 1.) Nariya Cho et al.3 in 2008 studied a total of 100 patients with non palpable breast masses in women in the age group of 24-67 years; mean age, 46 years.

On histopathology, out of the 60 patients with breast masses, 36 were found to be benign and 24 malignant.

In a study by Zhi hui et al. a total of 296 breast lesions were examined histologically. Histologic analysis showed that 209 (70.6%) of 296 lesions were benign and 87 (29.4%) of 296 lesions were malignant.

In our study maximum number of patients in the fourth decade of life were detected to have benign lesions, whereas malignancy was commonly seen in the sixth decade. Sohaib Akhtar et al. in 2013 noted that majority of benign lesions were seen in the third decade of life and maximum cases of malignant lesions were seen in the fourth decade of