Objectives: The purpose of this study was to evaluate diagnostic performance of grayscale ultrasonography and strain elastography in distinguishing between benign and malignant solid breast masses, with cytological and histopathological results as reference standard.

Materials and Methods: Total 100 solid palpable breast masses in 100 women with mean age 38.95 years were studied using BI-RADS (Breast Imaging Recording and Data System) lexicon and strain ratio (SR) in the same settings and categorized into benign and malignant groups. Comparative analysis of sonographic parameters and strain ratio was done with cytological and histopathological diagnosis. Statistical analysis included sensitivity, specificity, and positive and negative predictive values for both gray scale ultrasonography and strain ratio.

Results: Cytological and histopathological diagnosis revealed 62 benign and 38 malignant lesions.  Gray scale ultrasonography had sensitivity of 92.11%, specificity of 83.87%, positive predictive value of 77.78 % and negative predictive value of 94.55 %.  For strain ratio, the mean ± standard deviation was6.16±2.92 for malignant lesions and 2.41±1.65 for benign lesions (p <0.001).  By using best cut-off of 3 between benign and malignant, sensitivity of 89.47%, specificity of 85.48%, positive predictive value of 79.07%, and negative predictive value of 92.98% obtained for strain ratio.

Conclusion: By combining gray scale ultrasonography and strain elastography the number of false results can be reduced with increase in overall yield of examination and subsequent reduction of unnecessary biopsies.

Keywords: Breast; Gray scale ultrasonography; Strain ratio; Neoplasm

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Dr Anjali Pravinkumar Wasadikar

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