Can strain elastography improve the characterization of breast lesions identified during second-look MRI-directed sonographic examination?

PURPOSE: To evaluate strain elastography as a complementary tool for characterization of lesions identified during second-look MRI-directed sonographic examination.

METHODS: We reviewed 83 breast lesions evaluated with MRI, secondlook ultrasound (US) and strain elastography in 75 consecutive patients (median age, 56 years). US-guided biopsies were performed in all cases.

RESULTS: After histopathological examination, 44 lesions were benign, 38 were malignant and 1 was high-risk. At MRI, the mean size of the lesions was 12 mm. Forty lesions (48.2%) appeared as masses, 30 (36.1%) as "non-masses" and 13 (15.7%) as "foci." At second-look US examination, 56 (67.5%) appeared as masses (mean size, 7 mm) and 27 (32.5%) as non-masses (mean size, 14 mm). At strain elastography, among the 39 malignant/high risk lesions, 5 (12.8%) had a score of 4 or 5, whereas 16 (41%) had a score of 1 and 2 (false negative). Among the 44 benign lesions, 36 (82%) had a score of 1 or 2, whereas none had a score of 5. Sensitivity and specificity of strain elastography in the diagnosis of breast cancer were 58% and 81%, respectively.

CONCLUSION: The addition of strain elastography offers no benefit in the characterization of lesions identified on second-look US after breast MRI.(E1, 3).