[Ultrasound elastography techniques in breast cancer]

Elasticity assessment of breast lesions can also be used as an associated criterion in the B‑mode ultrasound (US) assessment for differentiation between benign or malignant lesions.

The goal was to identify techniques available to measure US elasticity, assess the use of B‑mode BI-RADS® classification combined with elastography, and identify which artefacts influence the US elasticity result.

Based on different studies and meta-analyses, clinical application in daily routine of the presented US elastography techniques will be investigated concerning the statistical performance of semi-quantitative and quantitative cut-off values to differentiate benign from malignant lesions.

Supported by meta-analyses, all presented US elastography techniques improve the specificity by decreasing the B‑mode sensitivity. In the literature the semi-quantitative and quantitative cut-off values often vary considerably. The interobserver variability of strain elastography shows a fair agreement and the interobserver variability of shear wave elastography a substantial agreement.

Considering the limitations and artefacts of each technique, US elastography is able to enhance the true positive and true negative results. In the case of a higher B‑mode BI-RADS® classification (4b, 4c, 5) or in a high-risk situation to develop breast cancer, a large core needle biopsy should be performed despite lesion softness in elastography.