title: Shear wave elastography contribution in ultrasound diagnosis management of breast lesions.
abstract: OBJECTIVE
  To determine the diagnosis performance of shear wave elastography in the differentiation of benign and malignant breast lesions and the factors influencing the elasticity values. To suggest an appropriate management of breast lesions using the ultrasound-elastography combination.
  
  
  METHODS
  Monocentric retrospective study of 167 breast lesions classified by conventional ultrasound as BI-RADS category 3 or higher that underwent an elastography study and histological analysis.
  
  
  RESULTS
  The analysis of qualitative parameters, according to the classification established in this study, allows us to obtain a sensitivity of 91.1% and a specificity of 92.3%. These values are very close to or better than the quantitative parameters Emax and Emean. Different Emax thresholds values were established based on the long axis of the lesion and its palpable character, which appeared to be significant factors influencing elasticity. The management of breast lesions by combining ultrasound and elastography, as proposed here, allows us to keep the sensitivity of an ultrasound (96%), while doubling its specificity (86.2% versus 43.1%).
  
  
  CONCLUSIONS
  With the complementary nature of their performance, the combination of conventional ultrasound and shear wave elastography can improve the management of breast lesions. The qualitative classification proposed appears to be relevant assistance in lesion characterization.
authors.affiliation: Senology and Breast Imaging Department, Centre Régional de Lutte Contre le Cancer d'Auvergne, 58, rue Montalembert, 63000 Clermont-Ferrand, France. Electronic address: tklotz@chu-clermontferrand.fr.
authors.forename: T
authors.initials: T
authors.lastname: Klotz
authors.affiliation: Senology and Breast Imaging Department, Centre Régional de Lutte Contre le Cancer d'Auvergne, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
authors.forename: V
authors.initials: V
authors.lastname: Boussion
authors.affiliation: Clinical Research Department, Centre Régional de Lutte Contre le Cancer d'Auvergne, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
authors.forename: F
authors.initials: F
authors.lastname: Kwiatkowski
authors.affiliation: Senology and Breast Imaging Department, Centre Régional de Lutte Contre le Cancer d'Auvergne, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
authors.forename: V
authors.initials: V
authors.lastname: Dieu-de Fraissinette
authors.affiliation: Senology and Breast Imaging Department, Centre Régional de Lutte Contre le Cancer d'Auvergne, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
authors.forename: A
authors.initials: A
authors.lastname: Bailly-Glatre
authors.affiliation: Senology and Breast Imaging Department, Centre Régional de Lutte Contre le Cancer d'Auvergne, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
authors.forename: S
authors.initials: S
authors.lastname: Lemery
authors.affiliation: B Radiology Department, CHU Gabriel-Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
authors.forename: L
authors.initials: L
authors.lastname: Boyer
mesh_terms: D001940:Breast / Q000473:pathology; D001941:Breast Diseases / Q000175:diagnosis; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D005602:France; D006801:Humans; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000379:methods*
keywords: BI-RADS classification; Breast; Elastography; Qualitative classification; Ultrasound