Predictive value of elastography (Shear-Wave and Elasticity Index) in differentiating benign from malignant breast...

Evidence on the usefulness of quantitative elastography in the characterization of breast lesions remains limited in Latin America and scarce in Peru. This study aims to fill a relevant scientific gap by establishing specific cut-off points to optimize diagnostic interpretation and improve accuracy in differentiating benign from malignant lesions.

An observational, retrospective, and analytical study was conducted in 189 patients who underwent breast elastography between October 2024 and September 2025. Clinical and radiological variables were analysed. Bivariate tests and multivariate binary logistic regression were applied to identify independent predictors of malignancy. The cut-off points were determined via receiver operating characteristic (ROC) curve analysis.

Of the 85 lesions with histopathological confirmation, 54 (63.5%) were malignant, and 31 (36.5%) were benign. Malignant lesions presented significantly greater values of the elastography index (2.5 vs. 1.9; p = 0.001) and shear-wave elastography (SWE) (53 vs. 43 kPa; p < 0.001). According to the adjusted model, the Breast Imaging Reporting and Data System (BI-RADS) category remained the most relevant radiological predictor, suggesting that elastography values can be considered complementary for more accurate classification. The optimal SWE cut-off value of ≥ 47.5 kPa demonstrated acceptable diagnostic performance, with a sensitivity of 79.6% and specificity of 67.7%, indicating an adequate ability to distinguish between benign and malignant breast lesions.

This study represents one of the first examples of Peruvian evidence contributing scientific information on the application of quantitative elastography in the evaluation of breast lesions.