Usefulness of ultrasound elastography in reducing the number of Breast Imaging Reporting and Data System category 3 lesions on ultrasonography

Abstract

Purpose:To evaluate the negative predictive value (NPV) of ultrasound (US) elastography for non-palpable Breast Imaging Reporting and Data System (BI-RADS) category 3 lesions on ultrasonography and to determine whether US elastography is helpful in reducing the number of BI-RADS category 3 lesions on ultrasonography.Methods:Two hundred seventy-six consecutive, non-palpable BI-RADS category 3 lesions in 256 women who underwent US elastography and US-guided core biopsy, and who had at least 12 months of follow-up data, comprised our study group. The BI-RADS final assessment category and elasticity score were prospectively and independently classified. The rate of malignancy and NPV according to the elasticity score were analysed. We also investigated whether there was a subset of BI-RADS category 3 lesions that were of benign histology but negative on elastography.Results:Of the 276 non-palpable BI-RADS category 3 lesions, three lesions (1.0%) were finally confirmed as ductal carcinomas in situ. No cancers were found in the remaining 273 lesions with benign biopsy histology at a mean follow-up of 39.4 months (range, 12 to 72 months). The NPV of a negative elasticity score (elasticity score of 1) was 99.3% (165 of 166). If BI-RADS category 3 lesions showing a negative elasticity score were downgraded to BI-RADS category 2, 60.4% (165 of 273) of them with benign histology could have been safely followed without biopsy with an increased malignancy rate from 1% (3 of 276) to 1.8% (2 of 110), which is not significantly higher (P=0.626).Conclusion:US elastography has the potential to reduce the number of BI-RADS category 3 lesions on ultrasonography.

Breast diagnosis: Concordance analysis between the BI-RADS classification and Tsukuba sonoelastography score

“…If we take a close look to our correlative analysis ( Fig. 2 , 3 , 5 ) it may be noted that the 1, 2 and BGR elasticity scores are mostly assigned to BI-RADS II and III benign lesions such as cysts, hamartomas, lipomas, hematomas, non-palpable fibroadenomas or mastopathic nodules – a result concordant with literature data [ 13 , 14 , 15 , 16 ]. In the enumeration above the cystic lesions classified as BI-RADS III ( Fig 8a ) or IV (1 palpable inflammatory cyst – Fig.…”

Comparison of Ultrasound Elastography and Color Doppler Ultrasonography for Distinguishing Small Triple‐Negative Breast Cancer From Fibroadenoma

“…The elasticity of breast masses is harder in malignant lesions than in benign lesions and harder in infiltrative breast malignancy than in in situ lesions, indicating that the negative predictive value of a negative elasticity score is 99.3% . Berg et al suggested that the maximum lesion diameter had a significant impact on maximum lesion stiffness ( P < .0001), with larger masses being stiffer than smaller masses for most histopathologic entities as assessed by shear wave elastography.…”

BI-RADS 3: Current and Future Use of Probably Benign

“…166 had negative elastograms with 1 of those patients having DCIS. If the negative elastograms were used to change the assessment from BI-RADS 3 to BI-RADS 2, in this cohort the malignancy rate would have changed from 1 to 1.8% [ 67 ]. Larger studies that include some invasive cancers in the BI-RADS 3 group are needed to validate these results.…”