Breast elastography is more accurate for diagnosing breast cancer

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Breast elastography allows physicians to give a more accurate diagnosis of breast cancer, according to a study presented this week at the 2009 annual meeting of the American Roentgen Ray Society (ARRS) in Boston

Breast elastography is a new technique which looks at the mechanical properties of tissues, as opposed to conventional ultrasound which looks at the backscatter of transmitted ultrasound waves through tissues.

Llewellyn Sim, MD, and colleagues from the Singapore General Hospital in Singapore, sought to compare the clinical performance of parameters used in elastography with conventional ultrasound features in distinguishing between benign and malignant breast lesions.

The researchers evaluated 99 women with 110 sonographically visible lesions with ultrasound, elastography and combined ultrasound and elastography; and found that 26 lesions were malignant and 84 were benign.

"All breast cancers (100 percent) in the study were diagnosed correctly by elastography alone compared to 88.5 percent by conventional ultrasound," Sim said. "The use of breast elastography alone or combined with ultrasound provides a more accurate diagnosis of breast cancer."

"Breast elastography improves the sonographic diagnosis of breast cancer. It also potentially reduces unnecessary work-up, i.e. biopsies of benign breast lesions and patient anxiety," he said.

"Breast radiologists will see elastography in a different light when they realize that it has come of age and outperforms conventional breast ultrasound. With the sterling results and knowledge gained from my study, I am more confident in using elastography to assist me in obtaining a more accurate diagnosis of breast lesions detected with ultrasound in my daily clinical practice," said Sim.

The authors concluded that breast elastography has a higher sensitivity, specificity and accuracy than conventional ultrasound. Combined ultrasound and elastography gives higher specificity and accuracy but reduces sensitivity, relative to elastography alone. Area and distance ratios on elastography are superior to every sonographic feature in distinguishing benign and malignant breast lesions.

Sim and colleagues added that a "combined algorithm consisting of both elastographic parameters and ultrasound features enables a more accurate diagnosis of breast cancer. This can be used in a computer-aided diagnosis program for analysis of breast lesions."