ROLE OF ULTRASONOGRAPHIC ELASTOGRAPHY IN THE DIFFERENTIAL DIAGNOSIS OF BREAST MASSES AND ITS CONTRIBUTION TO CLASSICAL ULTRASONOGRAPHIC EVALUATION

2021 ◽  
pp. 48-50
Author(s):  
Ashok Kumar Verma ◽  
Rashmi Rashmi ◽  
Rakesh Kumar Verma ◽  
Mahendra Kumar Pandey
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
Diagnostic Performance ◽  
Breast Biopsy ◽  
Strain Ratio ◽  
Breast Lesions ◽  
Breast Masses ◽  
Screening Programs ◽  
Imaging Department ◽  
Malignant Breast

Introduction: India is experiencing an unprecedented rise in the number of breast cancer cases across all sections of society. Breast cancer is now the most common malignancy in women and the second leading cause of cancer- related mortality. Breast cancer is quite easily and effectively treated, provided it is detected in it's early stages. There is a drastic drop in the survival rates when women present with advanced stage of breast cancer, regardless of the setting. Unfortunately, women in resource-poor and developing countries, like India, generally present at a later stage of disease than women elsewhere, partly due to the absence of effective awareness programs and partly due to the lack of proper mass screening programs Aims And Objectives: The diagnostic performance of elastography in differentiating benign from malignant breast lesions. To assess whether elastography has the potential to reduce the need for breast biopsy /FNAC. Cut off value of Strain Ratio for benign versus malignant breast lesions. Further characterize BI-RADS 3 lesions using elastography Materials And Methods: The study was approved by the GSVM MEDICAL COLLEGE AND LLR HOSPITAL Ethics Committee. All patients that presented to the Radiology and Imaging Department of LLR HOSPITAL for diagnostic work up for breast pathology were included in the study. After obtaining a written and signed informed consent from all patients, they were subjected to conventional B-Mode ultrasonography followed by elastography. All diagnostic breast imaging was done with Samsung RS80A ultrasound machine using linear array transducer of frequency 5-12MHz.Observations & Results: The elastography patterns for each lesion were assessed and documented in color scale. Color images were constructed automatically and displayed as a color-overlay on the B-mode image. The color pattern of each lesion was then evaluated on a scale of 1-5 according to the Tsukuba elasticity scoring system. Conclusion: Strain Ratio cutoff of 3.3 is a sensitive parameter to differentiate benign and malignant breast lesions. Elastography is a specic test for differentiating benign and malignant breast lesions. The combined use of elasticity score, strain ratio and B- Mode sonographyincreases the diagnostic performance in distinguishing benign from malignant breast masses.

Diagnostic value of various vascular features of breast cancer by age

2021 ◽  
pp. 1-9
Author(s):  
Jia Lin ◽  
Wenqiang Lin ◽  
Liang Xu ◽  
Teng Lin
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
Critical Role ◽  
Added Value ◽  
Breast Lesions ◽  
Diagnostic Efficiency ◽  
Complex Flow ◽  
Diagnostic Efficacy ◽  
Breast Masses ◽  
Malignant Breast

BACKGROUND: Tumor angiogenesis plays a critical role in the growth and metastasis of breast cancer and evaluating the added value of vascular features to Breast Imaging Reporting and Data System (BI-RADS) in differentiating malignant nodules from benign ones is essential. Micro-flow Imaging (MFI) is a promising noninvasive diagnostic method for the microvessels in breast tumors, but its precise value is still uncertain. OBJECTIVES: Understanding whether malignant tumor vascular characteristics by MFI are associated with breast cancer and whether the diagnostic efficiency varies by age. MATERIALS AND METHODS: We used B-mode Ultrasound and MFI to detect the characteristics of 153 solid breast lesions. Two investigators reviewed the vessels images by MFI and assessed the vascular features, respectively. Evaluating diagnostic efficacy of different vascular features combined with BI-RADS in different age groups. RESULTS: The mean size of lesions is 19.4 (range 18–78) mm. There were 94 breast masses in benign, while 59 breast masses in malignant by pathology. III Adler classification, penetrating vessels, and complex flow pattern showed a positive association with a high risk of malignant breast lesions (p <  0.05). BI-RADS combined with vessel characteristics show better improvement of diagnostic performance of breast lesions in the elderly group than in the young group. CONCLUSIONS: Vascular features by MFI contribute to malignant breast masses’ diagnosis, and the association might be modified by age.

A qualitative and quantitative assessment of simultaneous strain, shear wave, and point shear wave elastography to distinguish malignant and benign breast lesions

2020 ◽  
pp. 028418512096142
Author(s):  
Yasemin Altıntas ◽  
Mehmet Bayrak ◽  
Ömer Alabaz ◽  
Medih Celiktas
Keyword(s):  
Shear Wave ◽  
Diagnostic Performance ◽  
Area Under The Curve ◽  
Shear Wave Elastography ◽  
Strain Ratio ◽  
Breast Lesions ◽  
Breast Masses ◽  
Malignant Breast ◽  
The Mean ◽  
Us Elastography

Background Ultrasound (US) elastography has become a routine instrument in ultrasonographic diagnosis that measures the consistency and stiffness of tissues. Purpose To distinguish benign and malignant breast masses using a single US system by comparing the diagnostic parameters of three kinds of breast elastography simultaneously added to B-mode ultrasonography. Material and Methods A total of 163 breast lesions in 159 consecutive women who underwent US-guided core needle biopsy were included in this prospective study. Before the biopsy, the lesions were examined with B-mode ultrasonography and strain (SE), shear wave (SWE), and point shear wave (STQ) elastography. The strain ratio was computed and the Tsukuba score determined. The mean elasticity values using SWE and STQ were computed and converted to Young’s modulus E (kPa). Results All SE, SWE, and STQ parameters showed similar diagnostic performance. The SE score, SE ratio, SWEmean, SWEmax, STQmean, and STQmax yielded higher specificity than B-mode US alone to differentiate benign and malignant masses. The sensitivity of B-mode US, SWE, and STQ was slightly higher than that of the SE score and SE ratio. The SE score, SE ratio, SWEmean, SWEmax, STQmean, and STQmax had significantly higher positive predictive value and diagnostic accuracy than B-mode US alone. The area under the curve for each of these elastography methods in differentiating benign and malignant breast lesions was 0.93, 0.93, 0.98, 0.97, 0.98, and 0.96, respectively; P<0.001 for all measurements. Conclusion SE (ratio and score), SWE, and STQ had higher diagnostic performance individually than B-mode US alone in distinguishing between malignant and benign breast masses.

scholarly journals Qualitative and quantitative strain and shear wave elastography paradigm in differentiation of breast lesions

2022 ◽  
Vol 53 (1) ◽  
Author(s):  
Roaa M. A. Shehata ◽  
Mostafa A. M. El-Sharkawy ◽  
Omar M. Mahmoud ◽  
Hosam M. Kamel
Keyword(s):  
Shear Wave ◽  
Diagnostic Performance ◽  
Strain Ratio ◽  
Breast Lesions ◽  
Breast Masses ◽  
Significant Difference ◽  
Malignant Breast ◽  
Malignant Lesions ◽  
The Mean ◽  
Sensitivity Specificity

Abstract Background Breast cancer is the most common life-threatening cancer in women worldwide. A high number of women are going through biopsy procedures for characterization of breast masses every day and yet 75% of the pathological results prove these masses to be benign. Ultrasound (US) elastography is a non-invasive technique that measures tissue stiffness. It is convenient for differentiating benign from malignant breast tumors. Our study aims to evaluate the role of qualitative ultrasound elastography scoring (ES), quantitative mass strain ratio (SR), and shear wave elasticity ratio (SWER) in differentiation between benign and malignant breast lesions. Results Among 51 female patients with 77 histopathologically proved breast lesions, 57 breast masses were malignant and 20 were benign. All patients were examined by B-mode ultrasound then strain and shear wave elastographic examinations using ultrasound machine (Logiq E9, GE Medical Systems) with 8.5–12 MHz high-frequency probes. Our study showed that ES best cut-off point > 3 with sensitivity, specificity, PPV, NPP, accuracy was 94.7%, 85%, 94.7%, 85%, 90.9%, respectively, and AUC = 0.926 at P < 0.001, mass SR the best cut-off point > 4.6 with sensitivity, specificity, PPV, NPP, accuracy was 96.5%, 80%, 93.2%, 88.9%, 92.2%, respectively, and AUC = 0.860 at P < 0.001, SWER the best cut-off value > 4.9 with sensitivity, specificity, PPV, NPP and accuracy was 91.2%, 80%, 92.9%, 76.2%, 93.5%, respectively, and AUC = 0.890 at P < 0.001. The mean mass strain ratio for malignant lesions is 10.1 ± 3.7 SD and for solid benign lesions 4.7 ± 4.3 SD (p value 0.001). The mean shear wave elasticity ratio for malignant lesions is 10.6 ± 5.4 SD and for benign (solid and cystic) lesions 3.6 ± 4.2 SD. Using ROC curve and Youden index, the difference in diagnostic performance between ES, SR and SWER was not significant in differentiation between benign and malignant breast lesions and also was non-significant difference when comparing them with conventional US alone. Conclusion ES, SR, and SWER have a high diagnostic performance in differentiating malignant from benign breast lesions with no statistically significant difference between them.

Clinical Application of Computer-Aided Diagnosis According to S-Detect in Category 4 Breast Lesions: Prospective Single-Center Study (Preprint)

2020 ◽  
Author(s):  
Pengfei Sun ◽  
Chen Chen ◽  
Weiqi Wang ◽  
Lei Liang ◽  
Dan Luo ◽  
...  
Keyword(s):  
Clinical Management ◽  
Diagnostic Performance ◽  
Breast Biopsy ◽  
Computer Aided Diagnosis ◽  
Breast Lesions ◽  
Breast Masses ◽  
Computer Aided ◽  
Conventional Ultrasound ◽  
Us Findings ◽  
Aided Diagnosis

BACKGROUND Computer-aided diagnosis (CAD) is a useful tool that can provide a reference for the differential diagnosis of benign and malignant breast lesion. Previous studies have demonstrated that CAD can improve the diagnostic performance. However, conventional ultrasound (US) combined with CAD were used to adjust the classification of category 4 lesions has been few assessed. OBJECTIVE The objective of our study was to evaluate the diagnosis performance of conventional ultrasound combined with a CAD system S-Detect in the category of BI-RADS 4 breast lesions. METHODS Between December 2018 and May 2020, we enrolled patients in this study who received conventional ultrasound and S-Detect before US-guided biopsy or surgical excision. The diagnostic performance was compared between US findings only and the combined use of US findings with S-Detect, which were correlated with pathology results. RESULTS A total of 98 patients (mean age 51.06 ±16.25 years, range 22-81) with 110 breast masses (mean size1.97±1.38cm, range0.6-8.5) were included in this study. Of the 110 breast masses, 64/110 (58.18%) were benign, 46/110 (41.82%) were malignant. Compared with conventional ultrasound, a significant increase in specificity (0% to 53.12%, P<.001), accuracy (41.81% to70.19%, P<.001) were noted, with no statistically significant decrease on sensitivity(100% to 95.65% ,P=.48). According to S-Detect-guided US BI-RADS re-classification, 30 out of 110 (27.27%) breast lesions underwent a correct change in clinical management, 74of 110 (67.27%) breast lesions underwent no change and 6 of 110 (5.45%) breast lesions underwent an incorrect change in clinical management. The biopsy rate decreased from 100% to 67.27 % (P<.001).Benign masses among subcategory 4a had higher rates of possibly benign assessment on S-Detect for the US only (60% to 0%, P<.001). CONCLUSIONS S-Detect can be used as an additional diagnostic tool to improve the specificity and accuracy in clinical practice. S-Detect have the potential to be used in downgrading benign masses misclassified as BI-RADS category 4 on US by radiologist, and may reduce unnecessary breast biopsy. CLINICALTRIAL none

scholarly journals Section Discrepancy and Diagnostic Performance of Breast Lesions in Two-dimensional Ultrasound by Dynamic Videos versus Static Images

2021 ◽  
Author(s):  
Dinghong Yang ◽  
Xiaoyun Xiao ◽  
Haohu Wang ◽  
Huan Wu ◽  
Wei Qin ◽  
...  
Keyword(s):  
Breast Imaging ◽  
Diagnostic Performance ◽  
Architectural Distortion ◽  
Breast Lesions ◽  
Two Dimensional ◽  
Benign Lesions ◽  
Static Image ◽  
Malignant Breast ◽  
Static Images ◽  
Malignant Lesions

Background: Benign or malignant breast lesions with typical ultrasonic characteristics could be easily and correctly diagnosed with two-dimensional ultrasound (2D US). However, diagnosis of atypical lesions remains a challenge. Most atypical lesions have different ultrasonographic features with probe direction variation. Thus, the interpretation of ultrasonographic features based on static images empirically collected by sonographers might be inaccurate. We aimed to investigate the section discrepancy and diagnostic performance of breast lesions in 2D US by dynamic videos versus static images.Methods: Static images and dynamic videos based on two perpendicular planes of 468 breast lesions were collected and evaluated. The Breast Imaging and Reporting Data System (BI-RADS&#x00AE;) US lexicon was used. Category 3 was used as the cut-off point, and section discrepancy was defined as two perpendicular planes showing different BI-RADS categories (3 versus 4A, 4B, 4C, and 5).Results: This retrospective study included 315 benign and 153 malignant lesions. There were 53 and 50 lesions with section discrepancy during static and dynamic observations, respectively. The proportion of benign lesions with section discrepancy was significantly higher than that of malignant lesions (P &#x003C; 0.05) either in dynamic or static observation, and the contingency coefficient was 0.2 between section discrepancy and histopathology. Duct changes were more clearly depicted in dynamic videos than in static images (P &#x003C; 0.05) both in malignant and benign lesions. Calcification and architectural distortion were more sensitively detected by dynamic videos than with static images (P &#x003C; 0.05) in malignant lesions. The interpretation of &#x201C;margin&#x201D; significantly differed in benign lesions between static images and dynamic videos (P &#x003C; 0.05). The areas under the curve of static image-horizontal, static image-sagittal, dynamic video-horizontal, and dynamic video-sagittal were 0.807, 0.820, 0.837, and 0.846, respectively. The specificities of dynamic videos were higher than those of static images (P &#x003C; 0.05).Conclusion: Breast lesions have section discrepancy in 2D US. Observations based on dynamic videos could more accurately reflect lesion features and increase the specificity of US in the differentiation of atypical breast lesions.

scholarly journals Comparative sonographic review of benign and malignant breast masses

2018 ◽  
Vol 8 (1) ◽  
pp. 42
Author(s):  
Afodun A M ◽  
Eze E D ◽  
Quadri K K ◽  
Muhammed A O ◽  
Masud M A ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
Scar Tissue ◽  
Breast Masses ◽  
Ultrasound Findings ◽  
Malignant Breast ◽  
High Frequency Transducer ◽  
Focal Fibrosis ◽  
Made In

Complex breast masses may appear as suspicious ultrasound findings that usually warrant biopsy. Ductal cell carcinoma in-situ (DCIS) is a form of breast cancer with a non-uniform appearance and malignant potential. A longitudinal review of mammary gland ultrasound (with high frequency transducer) within a three-year period was conducted. Differential diagnosis of fibroadenoma, lactating adenoma, mastitis, galactocele, breast cancer, abscess and “general” masses greater than 16 mm in diameter was stratified. Based on the breast imaging reporting in data system (BIRADS), lesions were classified as benign or malignant and recommendations of cytology made in cases of observed overlap findings. Image sonomorphologic information on mass-echogenic halo and non-uniform orientation were documented; while malignant factors like scar tissue, focal fibrosis and papillomas may be associated with a false positive (conclusion) result. Doppler studies on further mass evaluation is encouraged.

scholarly journals The wavelia microwave breast imaging system–Tumour discriminating features and their clinical usefulness

2021 ◽  
pp. 20210907
Author(s):  
Brian M Moloney ◽  
Peter F McAnena ◽  
Sami M Elwahab ◽  
Angie Fasoula ◽  
Luc Duchesne ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
Breast Lesions ◽  
Conventional Imaging ◽  
Benign Lesions ◽  
Malignancy Risk ◽  
Malignant Breast ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Objective: The Wavelia Microwave Breast Imaging (MBI) system, based on non-ionising imaging technology, has demonstrated exciting potential in the detection and localisation of breast pathology in symptomatic patients. In this study, the ability of the system to accurately estimate the size and likelihood of malignancy of breast lesions is detailed, and its clinical usefulness determined. Methods: Institutional review board and Health Products Regulatory Authority (HPRA) approval were obtained. Patients were recruited from the symptomatic unit to three groups; Breast cancer (Group-1), unaspirated cysts (Group-2) and biopsied benign lesions (Group-3). MBI, radiological and histopathological findings were reviewed. MBI size estimations were compared with the sizes determined by conventional imaging and histopathology. A Quadratic Discriminant Analysis (QDA) classifier was trained in a 3D feature space to discriminate malignant from benign lesions. An independent review was performed by two independent breast radiologists. Results: 24 patients (11 Group-1, 8 Group-2 and 5 Group-3) underwent MBI. The Wavelia system was more accurate than conventional imaging in size estimation of breast cancers. The QDA accurately separated benign from malignant breast lesions in 88.5% of cases. The addition of MBI and the Wavelia malignancy risk calculation was deemed useful by the two radiologists in 70.6% of cases. Conclusion: The results from this MBI investigation demonstrate the potential of this novel system in estimating size and malignancy risk of breast lesions. This system holds significant promise as a potential non-invasive, comfortable, and harmless adjunct for breast cancer diagnosis. Further larger studies are under preparation to validate the findings of this study. Advances in knowledge: This study details the potential of the Wavelia MBI system in delineating size and malignancy risk of benign and malignant breast lesions in a symptomatic cohort. The usefulness of the Wavelia system is assessed in the clinical setting.

scholarly journals RETROSPECTIVE ANALYSIS OF MAMMOGRAM, SONOMAMMOGRAM AND ITS HISTOPATHOLOGICAL CORRELATION AS AN AID FOR DIAGNOSIS OF BREAST LESIONS

2021 ◽  
pp. 1-4
Author(s):  
Sathish babu ◽  
Arifkhan Sainudeen ◽  
Abdul Eksana
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
Ductal Carcinoma ◽  
Histopathological Examination ◽  
Benign Lesion ◽  
Malignant Lesion ◽  
Breast Lesions ◽  
Care Hospital ◽  
Malignant Breast ◽  
Malignant Lesions

INTRODUCTION: Breast cancer is the most common cancer impacting 2.1 million women each year and also relates to the most cancer related deaths in women. In 2018, it was estimated that 627,000 women died from breast cancer which approximates to 15 % of all cancer related deaths among women [1]. The triple test– clinical examination, mammography and core biopsy helps in differentiating benign and malignant lesions. Histopathological examination is considered being the gold standard test for confirming malignant lesions and forms the basis of management. AIM: To assess sensitivity of mammogram with ultrasonography in diagnosing various breast lesions and to correlate the categorized breast lesions (BI-RADS) with histopathology reports and thereby obtain specificity and NPV of evaluation using Mammogram and ultrasonography. STUDY DESIGN: Retrospective analytical study. Study Period: July 2018 – July 2019. METHODS: The results of ultrasonography and mammography of 72 cases diagnosed clinically with breast lesions over the period of one year in tertiary health care hospital were compared with histopathology reports. RESULTS: The mean age of the patients was 45.65 ± 3.19. Our results showed that in histopathology reports in 20 patients (27.78%) were malignant, 51 cases (70.83%) had benign disease and 1 case 1.39% was borderline malignant. Fibroadenoma was the commonest benign lesion whereas infiltrating ductal carcinoma was the most common malignant lesion. Breast Imaging – Reporting and Data System (BIRADS) by mammogram revealed category II in 54.1%, III in 20.8%, IV in 16.6% and V in 8.3%. The specificity of mammography alone in diagnosing malignant breast lesions was 90.1%. When combined (ultrasound and mammogram), the specificity in diagnosing malignant breast lesion was 98.5% CONCLUSION: Mammography and sono-mammogram plays an important role in the diagnostic and surgical management of breast lesions with correlative histopathology evaluation. The diagnostic accuracy shows significant improvement when mammogram was combined with ultrasound correlation and thereby improving sensitivity and specificity of diagnosing malignant breast lesions.

scholarly journals Evaluation of Focal Breast Lesions Using Ultrasound Elastography with FNAC and / or Histopathological Correlation - A Prospective Observational Study in the Region of Katihar, Bihar

2021 ◽  
Vol 8 (25) ◽  
pp. 2143-2148
Author(s):  
Raunak Sinha ◽  
Zafar Ali ◽  
Manish Jaiswal ◽  
Anuggya Mimansa
Keyword(s):  
Sensitivity And Specificity ◽  
Strain Ratio ◽  
Ultrasound Elastography ◽  
Vascular Involvement ◽  
Breast Lesions ◽  
Breast Masses ◽  
Medical College ◽  
Histopathological Correlation ◽  
Malignant Breast ◽  
Contiguous Spread

BACKGROUND We wanted to evaluate the sensitivity and specificity of ultrasound elastography in the detection and characterization of various breast masses and study its role in differentiating benign vs malignant breast masses with fine needle aspirarion cytology (FNAC) and/or histopathological correlation of its findings. METHODS A total of 120 patients with breast lesions were prospectively evaluated using ultrasonography (USG) in the Department of Radiodiagnosis at Katihar Medical College, Katihar, Bihar. After procuring consent from the patients, B-mode and elastography examination of all the patients was carried out simultaneously, using the Philips EPIQ 5G ultrasound machine. The findings were noted in a proforma for observation and further comparisons. The usefulness of elastography, regarding prediction of the nature of the mass (benign/malignant), delineation of its exact extent, and correlation with clinical/cytological diagnosis was studied. RESULTS A sensitivity of 97.0% and specificity of 86.7% was observed when a cut off value of 3 was used for elasticity score. A specificity of 95.5% and a sensitivity of 93.3% was observed when a cut off of 3.8 was used for strain ratio (SR). In all cases, the extent of the pathology, the local or contiguous spread and vascular involvement, predicted by ultrasound elastography examination corroborated well with the cytological findings. The results of this study are in concordance with results of studies that have been conducted previously. CONCLUSIONS Ultrasound elastography is a simple and rapid method that can improve the sensitivity and specificity of ultrasonography of focal breast lesions and can decrease the rate of unnecessary biopsies. The diagnostic accuracy of combined ultrasound and elastography is quite high and thus improves the diagnostic confidence of the cases under evaluation. KEYWORDS Elastography, Ultrasound, Focal Breast Lesions

US-Elastography for Breast Lesion Characterization: Prospective Comparison of US BIRADS, Strain Elastography and Shear wave Elastography

2020 ◽  
Author(s):  
Vito Cantisani ◽  
Emanuele David ◽  
Richard G. Barr ◽  
Maija Radzina ◽  
Valeria de Soccio ◽  
...  
Keyword(s):  
Shear Wave ◽  
Diagnostic Performance ◽  
Color Doppler ◽  
Shear Wave Elastography ◽  
Strain Ratio ◽  
Breast Lesions ◽  
Strain Elastography ◽  
Prospective Comparison ◽  
Malignant Breast ◽  
Sensitivity Specificity

Abstract Purpose To evaluate the diagnostic performance of strain elastography (SE) and 2 D shear wave elastography (SWE) and SE/SWE combination in comparison with conventional multiparametric ultrasound (US) with respect to improving BI-RADS classification results and differentiating benign and malignant breast lesions using a qualitative and quantitative assessment. Materials and Methods In this prospective study, 130 histologically proven breast masses were evaluated with baseline US, color Doppler ultrasound (CDUS), SE and SWE (Toshiba Aplio 500 with a 7–15 MHz wide-band linear transducer). Each lesion was classified according to the BIRADS lexicon by evaluating the size, the B-mode and color Doppler features, the SE qualitative (point color scale) and SE semi-quantitative (strain ratio) methods, and quantitative SWE. Histological results were compared with BIRADS, strain ratio (SR) and shear wave elastography (SWE) all performed by one investigator blinded to the clinical examination and mammographic results at the time of the US examination. The area under the ROC curve (AUC) was calculated to evaluate the diagnostic performance of B-mode US, SE, SWE, and their combination. Results Histological examination revealed 47 benign and 83 malignant breast lesions. The accuracy of SR was statistically significantly higher than SWE (sensitivity, specificity and AUC were 89.2 %, 76.6 % and 0.83 for SR and 72.3 %, 66.0 % and 0.69 for SWE, respectively, p = 0.003) but not higher than B-mode US (B-mode US sensitivity, specificity and AUC were 85.5 %, 78.8 %, 0.821, respectively, p = 1.000). Conclusion Our experience suggests that conventional US in combination with both SE and SWE is a valid tool that can be useful in the clinical setting, can improve BIRADS category assessment and may help in the differentiation of benign from malignant breast lesions, with SE having higher accuracy than SWE.

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