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.
 2015 The Authors. The Egyptian Society of Radiology and Nuclear Medicine. Production and hosting
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