Comparison of ultrasound elastography, mammography, and sonography in the diagnosis of solid breast lesions.
OBJECTIVE
The purpose of this study was to evaluate the value of ultrasound elastography (UE) in differentiating benign versus malignant lesions in the breast and compare it with conventional sonography and mammography.


METHODS
From September 2004 to May 2005, 296 solid lesions from 232 consecutive patients were diagnosed as benign or malignant by mammography and sonography and further analyzed with UE. The diagnostic results were compared with histopathologic findings. The sensitivity, specificity, accuracy, positive and negative predictive values, and false-positive and -negative rates were calculated for each modality and the combination of UE and sonography.


RESULTS
Of 296 lesions, 87 were histologically malignant, and 209 were benign. Ultrasound elastography was the most specific (95.7%) and had the lowest false-positive rate (4.3%) of the 3 modalities. The accuracy (88.2%) and positive predictive value (87.1%) of UE were higher than those of sonography (72.6% and 52.5%, respectively). The sensitivity values, negative predictive values, and false negative rates of the 3 modalities had no differences. A combination of UE and sonography had the best sensitivity (89.7%) and accuracy (93.9%) and the lowest false-negative rate (9.2%). The specificity (95.7%) and positive predictive value (89.7%) of the combination were better, and the false-positive rate (4.3%) of the combination was lower than those of mammography and sonography.


CONCLUSIONS
In a clinical trial with Chinese women, UE was superior to sonography and equal or superior to mammography in differentiating benign and malignant lesions in the breast. A combination of UE and sonography had the best results in detecting cancer and potentially could reduce unnecessary biopsy. Ultrasound elastography is a promising technique for evaluating breast lesions.
Zhi
Hui
H
Department of Ultrasound, Second Affiliated Hospital, Sun Yat-Sen University, Guangzhou China. baomingluo2005@126.com
Ou
Bing
B
Luo
Bao-Ming
BM
Feng
Xia
X
Wen
Yan-Ling
YL
Yang
Hai-Yun
HY
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D010173:Palpation / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000379:methods