Ultrasound and Strain Elastography in Evaluation of Suspicious Breast Masses

Zahraa Majid Abdulamir Almosawi --- Kassim Amir Hadi Taj-aldean --- Hadi Mohamed Ali Almusawi --- Ali A. Kadhim Abutiheen

Medical Journal of Babylon مجلة بابل الطبية
ISSN: 1812156X 23126760 Year: 2017 Volume: 14 Issue: 4 Pages: 616 -626
Publisher: Babylon University جامعة بابل


Breast cancer is the most prevalent type of cancer in Iraq, and the commonest among females worldwide. Ultrasound is an important widely used noninvasive modality in line with mammography and other methods for the detection and characterization of breast masses in routine clinical practice. Elastography is a recent promising method used as an adjuvant to ultrasound that improves performance, increase the specificity of interpretation in differentiating benign from malignant breast masses based on imaging tissue stiffness. We aim to evaluate the accuracy of ultrasound and elastography in diagnosis of suspicious malignant breast masses. A cross sectional study was conducted in Babylon and Kerbala January 15 to August 20, 2017. A consecutive sample of women with breast mass suggestive of malignancy were evaluated with ultrasonography and strain elastography prior to histopathological study. The five point Tsukuba elasticity score were used for differentiation of breast masses. Ethical approval was taken from the Research Ethical Committee in Babylon University- College of Medicine, and verbal consent was taken from each patient prior to enrolment. A total sample of (88) females with breast mass aged 16-69 years with a mean ± SD of 41.33 ± 12.57 years. Ultrasound diagnosed correctly (58) out of the (62) malignant breast masses with a sensitivity and specificity of 93.5% and 100% respectively. By using strain elastography the sensitivity increased to 98.4% with same specificity of 100% were only one malignant mass was missed. By using the ROC analysis, the Area Under the Curve and 95% confidence interval was 0.968 (0.931-1) and 0.992 (0.974-1) for ultrasound and elastography respectively. So when elastography is used with ultrasound, it increases its sensitivity, specificity and accuracy. Efforts needed to adapt and apply its use properly in Iraq through training programs for radiologists.


Breast mass --- Breast cancer --- Ultrasound --- Elastography --- Strain elastography.