Shear wave elastography in the diagnosis of breast non-mass lesions: factors associated with false negative and false positive results.
OBJECTIVE
To investigate factors related to false shear wave elastography (SWE) results for breast non-mass lesions (NMLs) detected by B-mode US.


METHODS
This retrospective study enrolled 152 NMLs detected by B-mode US and later pathologically confirmed (79 malignant, 73 benign). All lesions underwent B-mode US and SWE. Quantitative (mean elasticity [Emean]) and qualitative (maximum stiffness colour) SWE parameters were assessed, and 'Emean> 85.1 kPa' or 'stiff colour (green to red)' determined malignancy. Final SWE results were matched to pathology results. Multivariate logistic regression analysis identified factors associated with false SWE results for diagnosis of breast NMLs.


RESULTS
Associated calcifications (Emean: odds ratio [OR] = 7.60, P < 0.01; maximum stiffness colour: OR = 6.30, P = 0.02), in situ cancer compared to invasive cancer (maximum stiffness colour: OR = 5.29, P = 0.02), and lesion size (Emean: OR = 0.90, P < 0.01; maximum stiffness colour: OR = 0.91, P = 0.01) were significantly associated with false negative SWE results for malignant NMLs. Distance from the nipple (Emean: OR = 0.84, P = 0.03; maximum stiffness colour: OR = 0.93, P = 0.04) was significantly associated with false positive SWE results for benign NMLs.


CONCLUSIONS
Presence of associated calcifications, absence of the invasive component, and smaller lesion size for malignant NMLs and shorter distance from the nipple for benign NMLs are factors significantly associated with false SWE results.


CONCLUSIONS
• Calcification and size are associated with false negative SWE in malignant NMLs. • In situ cancer is associated with false negative SWE in malignant NMLs. • Distance from the nipple is associated with false positive SWE in benign NMLs. • These factors need consideration when performing SWE on breast NMLs.
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Gangnam-Gu, Seoul, 135-710, Korea.
So Yoon
SY
Park
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Gangnam-Gu, Seoul, 135-710, Korea. jisoo.choi@samsung.com.
Ji Soo
JS
Choi
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Gangnam-Gu, Seoul, 135-710, Korea.
Boo-Kyung
BK
Han
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Gangnam-Gu, Seoul, 135-710, Korea.
Eun Young
EY
Ko
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Gangnam-Gu, Seoul, 135-710, Korea.
Eun Sook
ES
Ko
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D012189:Retrospective Studies; D016217:Ultrasonography, Mammary / Q000379:methods*
Breast; False negative; False positive; Non-mass lesions; Shear wave elastography