title: Could ultrasonic elastography help the diagnosis of small (≤2 cm) breast cancer with the usage of sonographic BI-RADS classification?
abstract: OBJECTIVE
  To evaluate the additive value of ultrasound strain elastography (USE) to BI-RADS for the differentiation of benign and malignant breast small lesions.
  
  
  METHODS
  Breast masses (≤2 cm) with histological diagnosis examined by ultrasonography and USE in our department from April 2004 to December 2009 were reviewed. Conventional B-mode ultrasound findings were classified according to the BI-RADS classification. USE findings were classified according to the 5-point scale. Histological diagnosis was used as the reference standard.
  
  
  RESULTS
  401 (246 benign (61.3%), 155 malignant (38.7%)) from 370 consecutive patients were included in the study. Sensitivity and specificity were 90.3%, 68.3% for BI-RADS; 72.3%, 91.9% for USE. The sensitivity of BI-RADS was better than that of USE (P<0.05), while the specificity of USE was better than that of BI-RADS (P<0.05). A revised BI-RADS combined with USE results was proposed in this study. Sensitivity and specificity were 83.9% and 87.8% for revised BI-RADS. The diagnostic performance of revised BI-RADS was better than BI-RADS (P<0.05).
  
  
  CONCLUSIONS
  USE could give BI-RADS some help in the differentiation of benign and malignant breast small lesions. The addition of elastography to BI-RADS could improve the diagnostic performance in <2 cm lesions.
authors.affiliation: Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiangxi Rd, Guangzhou 510120, Guangdong Province, China. kendy181hui@yahoo.com.cn
authors.forename: Hui
authors.initials: H
authors.lastname: Zhi
authors.forename: Xiao-yun
authors.initials: XY
authors.lastname: Xiao
authors.forename: Bing
authors.initials: B
authors.lastname: Ou
authors.forename: Wen-jing
authors.initials: WJ
authors.lastname: Zhong
authors.forename: Zi-zhuo
authors.initials: ZZ
authors.lastname: Zhao
authors.forename: Xin-bao
authors.initials: XB
authors.lastname: Zhao
authors.forename: Hai-yun
authors.initials: HY
authors.lastname: Yang
authors.forename: Bao-ming
authors.initials: BM
authors.lastname: Luo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000379:methods*; D055815:Young Adult