Breast Shear Wave elastography and the war of differential diagnosis: are on the way to classify quantitatively breast pathology
Estela Fernández Cuadriello
Objectives: The fundamental purpose is to evaluate if elastography technique can predict the type of breast lesion conferring a numerical classification to different histopathological diagnosis. We also want to relate the BIRADS classification with the elastographic measurements in order to determine the point that increases the possibility of malignancy. Material and Methods: From January to November of 2015, we study 116 patients with an age between 19 and 82 years. 117 lesions are evaluated consecutive with ultrasound, elastography and biopsy. Two index are measured, the hardness in kPa and the propagation speed of the waves in m/sec, in the most suspicious areas of the nodules. The minimum, maximum, average and standard deviation values are calculated. All cases are correlated with their histopathology. Results: We found statistically significant differences (p <0.05) for the kPas measure between the cancer group and the benign pathology group (p <0.0001). With the measure kPas we could not predict the histopathological type of benign nodule, since there are no significant differences between patients with different diagnoses of benignity. The results for both the kPas and m/s measurements indicate statistically significant differences (p <0.05) of the BIRADS 4C and BIRADS 5 compared to the rest. Conclusion: The measures kPas and m/s allow to discern with a confidence level of 95% if a mammary nodule will be malignant or not, but it does not allow to differentiate between different types of benign nodules. They also allow us to discern with a 95% confidence level the patients with moderate or high probability of neoplasia (BIRADS 4C and BIRADS 5) of the rest.