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Role of elastography for downgrading BI-RADS category 4a breast lesions according to risk factors

 Jieun Koh  ;  Eun-Kyung Kim  ;  Min Jung Kim  ;  Jung Hyun Yoon  ;  Vivian Youngjean Park  ;  Hee Jung Moon 
 ACTA RADIOLOGICA, Vol.60(3) : 278-285, 2019 
Journal Title
Issue Date
Adult ; Aged ; Biopsy/methods ; Breast Neoplasms/diagnostic imaging* ; Breast Neoplasms/pathology ; Elasticity Imaging Techniques/methods* ; Female ; Humans ; Middle Aged ; Retrospective Studies ; Risk Factors ; Ultrasonography, Mammary/methods*
Breast cancer ; diagnosis ; elastography ; risk factors ; ultrasonography
BACKGROUND: Elastography has been introduced as an additional diagnostic tool to ultrasonography (US) which helps clinicians decide whether or not to perform biopsy on US-detected lesions.

PURPOSE: To evaluate the role of strain elastography in downgrading Breast Imaging Reporting and Data System (BI-RADS) category 4a breast lesions according to personal risk factors for breast cancer in asymptomatic women.

MATERIAL AND METHODS: Strain elastography features of a total of 255 asymptomatic category 4a lesions were classified as soft and not soft (intermediate and hard). Malignancy was confirmed by surgery or biopsy, and benignity was confirmed by surgery or biopsy with no change on US for at least six months. Malignancy rates of lesions with soft and not soft elastography were calculated according to the presence of risk factors.

RESULTS: Of 255 lesions, 25 (9.8%) were malignant and 230 (90.2%) were benign. Of 195 lesions in average-risk women, the malignancy rate of lesions with soft elastography was 1.5% (1/68), which was significantly lower than the 14.2% (18/127) of lesions with not soft elastography ( P = 0.004). Of 60 lesions in increased-risk women, the malignancy rate of lesions with soft elastography was 15.0% (3/20), which was not significantly different from the 7.5% (3/40) of lesions with not soft elastography ( P = 0.390).

CONCLUSION: In average-risk women, category 4a lesions with soft elastography could be followed up with US because of a low malignancy rate of 1.5%.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min Jung(김민정) ORCID logo https://orcid.org/0000-0003-4949-1237
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Moon, Hee Jung(문희정) ORCID logo https://orcid.org/0000-0002-5643-5885
Park, Vivian Youngjean(박영진) ORCID logo https://orcid.org/0000-0002-5135-4058
Yoon, Jung Hyun(윤정현) ORCID logo https://orcid.org/0000-0002-2100-3513
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