Comparison of qualitative and semiquantitative strain elastography in breast lesions for diagnostic accuracy

Background: Fine-needle aspiration biopsy (FNAB) in breast lesions offers accurate results in differentiating benign and malignant lesions. However, its role is unclear when core-needle biopsy (CNB) is available, the latter providing additional information regarding tumor grade, invasion, and hormone receptor status in malignant lesions. In benign breast lesions, especially in BIRADS category 4a and 4b, FNAB, and CNB provide similar pathological information, whereby FNAB may serve as a more rapid and cost-effective investigation. The study was planned to reevaluate the diagnostic accuracy of FNAB in BIRADS category 4a, 4b, and 4c lesions. Materials and Methods: FNAB and biopsy reports of all patients with breast lesions sent between September 1, 2018, and November 30, 2020, were collected and the International Academy of Cytology (IAC) Yokohama category and BIRADS score were recorded for each case. The rate of malignancy and the accuracy of FNAB in diagnosing malignancy were calculated for each BIRADS 4a, 4b, and 4c subgroup. Results: A total of 249 cases of BIRADS 4 lesions had corresponding cytology and histopathology diagnoses. FNAB showed high diagnostic accuracy in all BIRADS groups. A benign categorization was associated with a very low number of false-negative diagnoses, especially in BIRADS 4a lesions. Conclusion: The study reconfirms the excellent accuracy of breast FNAB using the IAC Yokohama system in diagnosing breast malignancies. Furthermore, BIRADS 4a lesions found to be belonging to the cytological benign category may be excluded from CRB and kept on clinical follow-up.

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Can strain US-elastography with strain ratio (SRE) improve the diagnostic accuracy in the assessment of breast lesions? Preliminary results

Journal of Ultrasound ◽

10.1007/s40477-020-00505-3 ◽

2020 ◽

Author(s):

Daniela Elia ◽

Daniele Fresilli ◽

Patrizia Pacini ◽

Sara Cardaccio ◽

Giorgia Polti ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Strain Ratio ◽

Breast Lesions ◽

Preliminary Results ◽

Us Elastography

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Comparison of the SRmax, SRave, and color map of strain-elastography in differentiating malignant from benign breast lesions

Acta Radiologica ◽

10.1177/0284185118773510 ◽

2018 ◽

Vol 60 (1) ◽

pp. 28-34

Author(s):

Jin Hee Moon ◽

Sung Hye Koh ◽

Sun-Young Park ◽

Ji-Young Hwang ◽

Ji Young Woo

Keyword(s):

Statistical Significance ◽

Roc Curves ◽

Strain Ratio ◽

Breast Lesions ◽

Strain Elastography ◽

Average Value ◽

Maximum Value ◽

Significant Difference ◽

Malignant Breast ◽

Color Map

Background The maximum value of the strain ratio (SR) is a newly developed measure in strain-elastography. Purpose To prospectively compare the diagnostic performance of three different measures of strain-elastography, the maximum value of the SR (SRmax), the average value of the SR (SRave), and the color map, for differentiating benign and malignant breast lesions. Material and Methods We obtained the SRmax and SRave of 314 lesions from 290 patients with the tissue to nodule SR and color map using a five-degree scoring system. The diagnostic performances of the SRmax, SRave, and color map were compared after obtaining the area under the receiver operating characteristic (ROC) curves (AUCs) of each parameter. Results The AUC of the SRmax (0.7674) was larger than the AUCs of the SRave (0.7138) and color map (0.6324), with statistical significance ( P = 0.0383 for SRmax vs. SRave, P = 0.0000 for SRmax vs. color map). The AUC of the SRave was larger than that of the color map; however, there was no significant difference. The optimal cut-off point of the SRmax that balanced the sensitivity (91.12%) and specificity (50.81%) was 5.16. Conclusion The SRmax is a more reliable diagnostic tool than the SRave and color map for differentiating benign and malignant breast lesions.

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Mammographic Fine Needle Biopsy of Non-Palpable Breast Lesions

Acta Radiologica Diagnosis ◽

10.1177/028418518402500405 ◽

1984 ◽

Vol 25 (4) ◽

pp. 273-276 ◽

Cited By ~ 7

Author(s):

M. Kehler ◽

U. Albrechtsson

Keyword(s):

Diagnostic Accuracy ◽

Needle Biopsy ◽

Fine Needle Biopsy ◽

Breast Lesions ◽

Malignant Cells ◽

Fine Needle ◽

The Past ◽

Palpable Breast ◽

Short Time ◽

Observation Period

Results with a previously described device for fine needle biopsies of non-palpable breast lesions are reported. During the past 5 years 182 biopsies were performed and 133 of these yielded diagnostic cell material. In the series, 41 carcinomas were found and fine needle biopsy in all demonstrated malignant or probably malignant cells. In the biopsies evaluated as benign or probably benign, malignancy has not been found during the observation period of 4 to 59 months (mean 21.5 months). The device described is cheap and biopsy is easily performed and, if necessary, repeated in a short time. The diagnostic accuracy is high and carcinomas as small as 3 mm in diameter have been diagnosed.

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Combined Use of Unguided FNA and CNB Increases the Diagnostic Accuracy for Palpable Breast Lesions

Diagnostic Cytopathology ◽

10.1002/dc.23484 ◽

2016 ◽

Vol 44 (7) ◽

pp. 578-581 ◽

Cited By ~ 3

Author(s):

Areej Al Nemer

Keyword(s):

Diagnostic Accuracy ◽

Breast Lesions ◽

Combined Use ◽

Palpable Breast

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Efficacy of FNAC in Diagnosis of Breast Lumps - A Retrospective Study

International Journal of Research and Review ◽

10.52403/ijrr.20210903 ◽

2021 ◽

Vol 8 (9) ◽

pp. 13-17

Author(s):

Oankar Kumar Maurya ◽

Richa . ◽

Manohar Lal

Keyword(s):

Retrospective Study ◽

Diagnostic Accuracy ◽

False Negative ◽

Patient Acceptance ◽

Breast Lesions ◽

Main Role ◽

Study Results ◽

Malignant Lesions ◽

Benign Breast Lesions ◽

Breast Lumps

Background: FNAC is an established and highly accurate method for diagnosis of breast lesions. Its further advantage is to give rapid diagnosis, cost-effectiveness, excellent patient acceptance and minimal or no morbidity. The study aimed to diagnose various breast masses before operation by FNAC and to compare the result of FNAC with histopathological study to assess the efficacy of FNAC. Materials and Methods: The study entitled “Efficacy of FNAC in diagnosis of Breast Lumps” is a retrospective study conducted in department of surgery with collaboration of pathology department at Nalanda Medical College and Hospital, Patna during the period of July 2017 to December 2019. During this period, 150 FNAC cases were selected for study. Results: Fibroadenoma was the most commonly diagnosed entity in benign breast lesions, followed by fibrocystic disease. Among malignant lesions, infiltrating ductal carcinoma was the most common. The overall diagnostic accuracy of FNAC in benign breast lesions was 94.59%. The fibroadenomas were correctly diagnosed in 92.96% cases. There were 5.41% false negative results in our series. There was no false positive result giving specificity of 100%. Conclusion: FNAC is an inexpensive, simple, safe and readily acceptable procedure to the patient and plays main role to provide rapid and accurate diagnosis of breast lumps. FNAC enables us to differentiate benign from malignant lesions with high sensitivity, specificity and diagnostic accuracy. Keywords: Breast Lump, FNAC, HPE: Histopathological Examination.

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ROLE OF ULTRASOUND STRAIN ELASTOGRAPHY FOR THE EVALUATION OF BREAST LESIONS

10.36106/gjra/2105109 ◽

2020 ◽

pp. 4-6

Author(s):

Deoyani S Sarjare ◽

Arti Anand ◽

Soumya Agrawal ◽

Shanas K. P. ◽

Sandhya Yeshwante

Keyword(s):

Predictive Value ◽

Breast Biopsy ◽

Mammographic Screening ◽

P Value ◽

Breast Lesions ◽

Chi Square ◽

Cross Sectional ◽

Strain Elastography ◽

Malignant Breast ◽

Breast Lumps

Introduction: Ultrasound (US) elastography is an emerging technique that can be used during breast US examination. Guidelines recommend mammographic screening and US for diagnosis of breast cancer. The specificity of these techniques is not high enough to prevent unnecessary biopsies. Hence there is need for a more specific technique to overcome this problem. This study aimed to evaluate the value of strain elastography (SE) for breast lesions. Materials and Methods: In this cross sectional observational study over 18 months, 60 women with palpable breast lumps were evaluated with conventional US and SE. Results obtained were correlated with histopathological findings for statistical analysis. Result: A statistically significant correlation was found between SE and histopathological outcome with a p value of 0.03(<0.05). The positive predictive value (PPV) was 76.92% and the negative predictive value (NPV) was 76.47% with Chi square= 8.4. Conclusion: Ultrasound with SE can substantially improve the possibility of differentiating benign from malignant breast lesions thereby limiting recourse to biopsy and considerably reducing the number of benign breast biopsy diagnoses.

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