Objectives
To evaluate diagnostic yield of mammography, B-mode ultrasound (US), ultrasound elastography (UE) and color Doppler used alone or in combination for differentiating breast lesions.
Patients and methods
Sixty women presented by breast lump underwent mammographic examination, B-mode US, color Doppler assessment and UE. The result of histopathological examination of excisional biopsy was used as gold standard for comparison of results.
Results
Mammography defined 36 patients had dense glandular breast and 24 patients had fatty parenchyma. Eleven patients had dense glandular parenchyma and 7 of those had fatty parenchyma had malignant lesions. Mean resistive index for malignant lesions was significantly higher than benign lesions. The mean strain ratio was significantly higher for malignant. Combined use of US and UE provided better diagnostic yield than US and Doppler, while combined use of US, UE and Doppler improved the diagnostic yield with high sensitivity and specificity and NPV of 95%. ROC curve analysis assured the high diagnostic yield of combination of US, UE and Doppler.
Conclusion
Combined use of B-mode US, UE and color Doppler achieved NPV of 95% thus allowed sparing of unnecessary invasive diagnostic procedures. UE as a sole diagnostic test has high sensitivity and specificity. Mammography could be used as screening test for its high sensitivity.
Abbreviations
• BI-RADS, Breast Imaging-Recording and Data System;
• ACR, American College of Radiology classification;
• PDUS, power Doppler ultrasound;
• RI, resistive index;
• ROI, region of interest;
• NPV, negative predictive value;
• DOT, diffuse optical tomography;
• ROC, relative operating characteristics curve;
• AUC, area under the curve