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Breast Elastography Sonography

Mark P. Bowes, PhD, and Usama Hasan, DO

*Medical Writer, Portland, Oregon.
Brookhaven Memorial Hospital Medical Center, East Patchogue, New York.
Address correspondence to: Mark P. Bowes, PhD, Medical Writer, 7135 SE 18th Avenue, Portland, OR, 97202. E-mail: mpbowes@gmail.com.
Disclosure Statement: Dr Bowes and Dr Hasan report having no financial or advisory relationships with corporate organizations related to this activity.

ABSTRACT

Regular breast cancer screening using mammography reduces cancer-related mortality, but results in a large number of potentially avoidable breast biopsy procedures. Magnetic resonance imaging or B-mode breast sonography are highly sensitive for cancer detection (ie, they identify nearly all breast tumors), but at the cost of relatively low specificity (ie, they fail to rule out cancer for many patients with benign lesions). Breast elastography is a newer technique that utilizes ultrasound to characterize the stiffness or compressibility of breast lesions. Malignant lesions typically exhibit less compression than benign lesions when exposed to the same external force, and measuring tissue deformation in response to an applied stress is a highly sensitive and specific technique for the detection of breast cancers. Three elastographic techniques are currently available (strain elastography, shear-wave elastography, and acoustic radiation force impulse [ARFI] imaging), each of which provides different information about underlying tissue stiffness. Elastography is especially useful for characterizing breast lesions with ambiguous findings on other imaging modalities (ie, with Breast Imaging-Reporting and Data System [BI-RADS] scores of 3 or 4). Clinical studies have demonstrated that the addition of breast elastography to B-mode sonography improves the specificity of breast cancer assessment without sacrificing sensitivity.

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