Evaluation of Focal Breast Lesions Using Ultrasound Elastography with FNAC and / or Histopathological Correlation - A Prospective Observational Study in the Region of Katihar, Bihar


Raunak Sinha1, Zafar Ali2, Manish Jaiswal3, Anuggya Mimansa4

We wanted to evaluate the sensitivity and specificity of ultrasound elastography
in the detection and characterization of various breast masses and study its role
in differentiating benign vs malignant breast masses with fine needle aspirarion
cytology (FNAC) and/or histopathological correlation of its findings.
A total of 120 patients with breast lesions were prospectively evaluated using
ultrasonography (USG) in the Department of Radiodiagnosis at Katihar Medical
College, Katihar, Bihar. After procuring consent from the patients, B-mode and
elastography examination of all the patients was carried out simultaneously, using
the Philips EPIQ 5G ultrasound machine. The findings were noted in a proforma
for observation and further comparisons. The usefulness of elastography,
regarding prediction of the nature of the mass (benign/malignant), delineation of
its exact extent, and correlation with clinical/cytological diagnosis was studied.
A sensitivity of 97.0% and specificity of 86.7% was observed when a cut off value
of 3 was used for elasticity score. A specificity of 95.5% and a sensitivity of 93.3%
was observed when a cut off of 3.8 was used for strain ratio (SR). In all cases, the
extent of the pathology, the local or contiguous spread and vascular involvement,
predicted by ultrasound elastography examination corroborated well with the
cytological findings. The results of this study are in concordance with results of
studies that have been conducted previously.
Ultrasound elastography is a simple and rapid method that can improve the
sensitivity and specificity of ultrasonography of focal breast lesions and can
decrease the rate of unnecessary biopsies. The diagnostic accuracy of combined
ultrasound and elastography is quite high and thus improves the diagnostic
confidence of the cases under evaluation.