EVALUATION OF FOCAL BREAST LESIONS USING ULTRASOUND ELASTOGRAPHY

Abstract

Introduction: Women’s breast cancer, from the past era especially, has been a worldwide public health problem. Breast cancer is considered as women’s primary cancer and causes high morbidity and mortality that induce attention for disease preventive programs.  From different cross-sectional studies specified the effectiveness of chemo-preventive measures for breast cancer in high risk women.  across all breast cancer risk groups, The relative risk reduction seems similar, however, the absolute risk reduction differs by risk factors for breast cancer and must balance against the potential harms for the decision for the appropriateness of treatment for individual women. Breast is the soft consistency made of fatty tissues that surround the breast glands. There are Different breast lesions are present fibro adenoma is considered the commonest benign tumor whereas the invasive ductal carcinoma is the commonest malignant tumor. Breast cancer has high incidence and its slow evolution before diagnosis which have emitting light to research on new diagnostic techniques. Recently ultrasound elastography is stiffness-based imaging has emerged as a new imaging technique which displays the tissue stiffness i.e. presenting hard or soft color-coded map that overlays the conventional B-mode image. Therefore, by elastography diagnosis can be improved for breast masses whether benign or malignant. Aim: The aim of this study was to evaluation of focal breast lesions using ultrasound elastography. Material and methods: This are the prospective cross- section study which is carried out on 50 female patients between the age group 20 to 70 years old visiting the ultrasound section of Rama medical College Hospital and Research Center Hapur in the Department of Radiology in a period of more than two year.  All the patients were referred to the Department of Radiology were diagnosed to have focal breast lesions by sonography were included in the study. From all patient complete history were taking and thorough clinical examination and ultrasound elastography done in the Department of Radiology in ultrasound section. Semi-quantitative elastography was used as Hitachi 7.5 MHz linear probe. For obtaining correct elastography images, definition of the ROI should be known. Then strain image was allowed analysis of the strain ratio values which were calculated. The results were also confirmed by histopathological examination, follow up and MRI mammography. Result: In this study 50 female patients with palpable breast lumps were included having the age group 20 to 70 years with a mean age of 46 years.  All patients were evaluated by gray scale ultrasound and sono-elastography examination with multiple different pathological lesions. According to the diagnosis in all the cases the lesions subdivided into 32 benign and 18 malignant lesions according to MRI, histopathological findings and follow up. Ultrasound elastography of breast lesions were done in all the patients’ being classified according to modified Ueno and Ito elasticity score system. Benign lesions which had elastography score as 1, 2, 3 and 4 are follow as 7(21.9%) lesions had elastography score 1, 16 (50%) lesions had elastography score 2, 2(6.3%) lesions had elastography score 3 and 7 (21.9%) lesions had elastography score 4. Whereas malignant breast lesions having elastography score 3, 4 and 5 are as follow:  3(16.7%) lesions had elastography score 3, 12(66.7%) lesions had elastography score 4 and 3(16.7%) lesions had elastography score 5. Conclusion: For examination of suspected breast cancer elastography should be used as an adjunct to the conventional B-mode examination. Elastography also provided other characterization of breast lesions which improve the specificity for low suspicion lesions achieved at conventional US.

Keywords: Breast lesions, ultrasound elastography operator characteristic analysis.