Can shear wave elastography be utilized as an additional tool for the assessment of non-mass breast lesions?

Sepideh Sefidbakht; Sara Haseli; Neda Khalili; Vahid Bazojoo; Pedram Keshavarz; Banafsheh Zeinali-Rafsanjani

doi:10.1177/1742271X21998721

Can shear wave elastography be utilized as an additional tool for the assessment of non-mass breast lesions?

Ultrasound. 2022 Feb;30(1):44-51. doi: 10.1177/1742271X21998721. Epub 2021 Mar 17.

Authors

Sepideh Sefidbakht¹, Sara Haseli^{1

2}, Neda Khalili³, Vahid Bazojoo¹, Pedram Keshavarz¹, Banafsheh Zeinali-Rafsanjani¹

Affiliations

¹ Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
² Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
³ School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Introduction: We aimed to describe shear wave elastography parameters of non-mass lesions of the breast and to assess the measures of diagnostic accuracy of shear wave elastography in the differentiation of non-mass lesions compared with conventional ultrasound, using histopathologic results as the reference standard.

Methods: This retrospective study included breast ultrasound-detected non-mass lesions with a confirmed pathologic diagnosis during a two-year study period. B-mode ultrasound and shear wave elastography were performed for all lesions before biopsy. Ultrasound features, shear wave elastography parameters (mean elasticity and maximum stiffness color), as well as Breast Imaging-Reporting and Data System categories were recorded for each lesion. Measures of diagnostic accuracy of ultrasound and ultrasound + shear wave elastography were also assessed.

Results: From a total of 567 breast lesions requiring core-needle biopsy, 49 (8.6%) were considered as non-mass lesions. Based on histopathologic reports, 32 patients (65.3%) had non-high-risk benign lesions, five (10.2%) had high-risk benign lesions, five (10.2%) had ductal carcinoma in situ, and seven (14.3%) had invasive carcinoma. There was no significant difference in patients' age and palpability between benign and malignant lesions (p = 0.16 and p = 0.12, respectively). Mean elasticity values and Breast Imaging-Reporting and Data System categories were significantly higher among malignant lesions compared with benign non-mass lesions (both p < 0.001). Furthermore, the addition of shear wave elastography to grayscale ultrasound increased the specificity, positive predictive value, and diagnostic accuracy.

Conclusion: The complementary use of shear wave elastography with conventional ultrasound might help in the differentiation of non-mass breast lesions and has the potential to decrease the frequency of unnecessary biopsies performed for benign non-mass lesions.

Keywords: BI-RADS; Breast; non-mass lesion; shear wave elastography; ultrasound.