Elastography: better results in the diagnosis of breast lesions compared to ultrasound and mammography?

Objective: Some diseases, such as breast cancer, lead to a change of tissue hardness. Real-time elastography is a new method to estimate the tissue hardness. The purpose of the prospective study was to compare the dignity of elastography, ultrasound, and mammography in the diagnosis of breast lesions. The objective was to find out, if elastography shows better diagnostic accuracy in characterising nodular breast lesions. Furthermore it was examined, if elastography brings different results in application on different sizes of the diagnosed lesions. Material and Methods: Elastography was investigated in 99 lesions (27 carcinomas, 22 cysts, 19 fibroadenomas, et al.) in 78 patients (average age 55 years), using the high-end HITACHI EUB 8500 ultrasound system, equipped with a 13– MHz linear transducer. All patients underwent mammographic and ultrasonic examination. The elastographic results were rated by the so called Ueno Score (1–2=benigne, 3–5=maligne), mammographic, and sonographic results according to the BIRADS criteria (1–3=benigne, 4–5=maligne). Afterwards, percutaneous samples for histologic diagnosis were taken. The elastographic, mammographic, and sonographic results were compared to those of the histological diagnosis. Results: 72 of 99 lesions were benign, 27 malign. Ultrasound had a sensitivity of 96%, specifity of 85%, respectively 81% and 85% for mammographic findings. The sensitivity of the elastography was 75%, the specifity 46%. A combination of elastography and ultrasound had the best sensitivity (100%) and specitivity (94%). Elastography showed better results for lesions with a maximum diameter of 3cm than for larger lesions. Conclusion: Elastography is easy and rapid to perform. Our initial results suggest that elastography is an additional method to assess the dignity of breast lesions. Due to the limited number of lesions included in the study, final conclusions are not yet possible. However, despite the small number of patient samples, these data provide an interesting contribution. The number of patients is currently being increased in order to get more significant results.