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Updated: Jun 5, 2026
Ultrasonographic Evaluation of Breast Cancer-related Lymphedema
Published on: January 12, 2017
New diagnostic criteria in real-time elastography for the assessment of breast lesions
B R Adamietz1, M Meier-Meitinger, P Fasching
1Universität Erlangen, Diagnostische Radiologie, Erlangen.
Purpose:
Elastography is a new ultrasonographic method that has been examined as a diagnostic tool for breast lesions. This study was intended to create and define new elastographic criteria allowing assessment of whether breast lesions are malignant or benign.
Materials And Methods:
217 patients with a total of 245 breast lesions of unknown malignancy underwent ultrasound examination. The new eSie Touch Elasticity Imaging technology (Siemens, Erlangen, Germany) was used with a 10-MHz linear transducer (Acuson Antares). Lesions were examined using B-mode and real-time elastography (RTE). Each lesion was histologically assessed by core biopsy. Five RTE characteristics were examined: elasticity proportion (EP), different location on RTE in comparison with B-mode (MV), different contrast patterns (SOS), dorsal lesion limitation visibility and different size on RTE in comparison with B-mode.
Results:
54 malignant lesions (54 %) appeared inelastic, in contrast to the benign control group (34.5 %; P = 0.001). A completely elastic pattern was visible in 10 malignant (10 %) and 39 benign lesions (26.9 %). MV was identified in 23 cases, with 22 of the lesions being malignant and one benign. The SOS was negative in 89 malignant lesions (89 %) and positive in 100 benign lesions. The dorsal lesion limitation was visible on RTE without B-mode in 88 malignant lesions (88 %) and 27 benign lesions (18.6 %). The size was assessed as larger in 45 malignant lesions (45 %) and seven benign lesions (4.8 %).
Conclusion:
SOS and a larger tumor size on RTE are specific characteristics of malignant breast lesions. EP, MV and distal mass border are further helpful signs to assess the malignancy of tumors.
