title: Elastography Complements Ultrasound as Principle Modality in Breast Lesion Assessment.
abstract: BACKGROUND
  The study aimed to improve breast cancer diagnosis with new ultrasound (US) modalities. We examined whether real-time elastography (RTE) complements the diagnostic performance of US.
  
  
  METHODS
  The Ethical Committee approved the study. Patients provided written informed consent and received a whole breast workup. Breast lesions were evaluated by US and RTE. Lesions were assessed by BI-RADS, Tsukuba score (TS) and strain ratio (SR).
  
  
  RESULTS
  The study included 164 breast lesions of which 101 were benign and 63 malignant. Women with benign lesions were predominantly premenopausal with sonographic dense breast tissue. Women with breast cancer were mostly postmenopausal, with a low sonographic density. Benign lesions had a mean TS of 2.05, which was significantly lower than the mean TS of 3.25 for malignant lesions. The SR for benign lesions (SR 1.83) was significantly smaller than for breast cancer (SR 4.83). Sensitivity and specificity was 95 and 81% for BI-RADS, 39 and 94% for TS, and 57 and 83% for SR, with a cutoff at 2.5. The combination of BI-RADS, TS and SR yielded a sensitivity of 95% and a specificity of 85%.
  
  
  CONCLUSIONS
  Besides morphologic features revealed by US, elastic properties of breast lesions obtained by RTE can be exploited for diagnostic breast imaging.
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital of Basel, Basel, Switzerland.
authors.forename: Katharina
authors.initials: K
authors.lastname: Redling
authors.forename: Fabienne
authors.initials: F
authors.lastname: Schwab
authors.forename: Matthias
authors.initials: M
authors.lastname: Siebert
authors.forename: Andy
authors.initials: A
authors.lastname: Schötzau
authors.forename: Rosanna
authors.initials: R
authors.lastname: Zanetti-Dällenbach
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001941:Breast Diseases / Q000000981:diagnostic imaging*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D054459:Elasticity Imaging Techniques / Q000592:standards*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000592:standards*; D055815:Young Adult