Could ultrasonic elastography help the diagnosis of breast cancer with the usage of sonographic BI-RADS classification?

•Our study is multi-center study at 8 different institutions from 3 geographic areas across China (North, South, and West).•This study reported the usefulness of strain elastography in combination with BI-RADS scoring system. Although we have several clinical studies suggesting that specificity may be improved by adding elastography to the scanning of breast masses and that the confidence level for malignancy will be improved, the present study revealed that elastography will contribute to BI-RADS greater for breast lesions <1 cm in diameter and in <50 year group.

ObjectivesThe purpose was to evaluate whether BI-RADS (the Breast Imaging Recording and Data System) combined with UE (ultrasound elastography) could improve the differentiation and characterization of benign and malignant breast lesions by comparing with BI-RADS.MethodsA total of 1080 patients with 1194 breast lesions were studied retrospectively at 8 different institutions from 3 geographic areas across China (North, South, and West) from June 2010 to March 2012. Each institutional ethic review board approved the study and all patients gave written informed consent. All the cases were examined by conventional US (ultrasonography) and UE prior to ultrasound-guided core biopsy. Performance of BI-RADS and BI-RADS combined with UE were compared in different size groups, age groups and area groups.ResultsBI-RADS combined with UE cloud improve the accuracy by 13.2% compared to BI-RADS alone for all lesions, 23.2% for <10 mm lesions, 13.3% for ≥10–20 mm lesions, 6.3% for ≥20 mm lesions, 18.4% for <50 years group, 1.7% for ≥50 years group, 13.7% for northern area group, 17.7% for southern area group and 4.4% for western area group.ConclusionsThe help which UE contributed to BI-RADS was greater for breast lesions <10 mm and <50 years group.