Diagnostic Accuracy of Shear Wave Elastography in Diagnosing Malignant Breast Lesions Taking Histopathology as Gold Standard

Abstract

Objective: To determine the diagnostic accuracy of shear wave elastography in identifying malignant breast lesions, taking histopathology as gold standard.

Methodology: This cross-sectional validation study was conducted at department of diagnostic radiology, Combined Military Hospital, Lahore from Jan to Dec 2024. A cohort of 170 female patients having clinically suspected breast lesions, aged 20-60 years, irrespective of marital status with breast lesion of duration >1 month and size >1 cm on conventional ultrasonography exhibiting features like spiculations, punctuate calcifications, duct extension and non-compressibility were included in the study. All patients underwent conventional B-mode ultrasonography followed by shear wave elastography. The results of shear wave elastography were then compared with histopathology findings to evaluate its diagnostic accuracy.

Results: Mean age was 45.47 ± 8.73 years. The mean size of the breast lesion was 3.24 ± 1.36 cm while mean duration of the disease was 12.92 ± 5.81 weeks. Shear wave elastography diagnosed 57 (33.5%) patients as having malignant lesions, whereas histopathology confirmed malignant breast lesions in 60 (35.3%). The calculated sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of shear wave elastography with histopathology as gold standard were 84.21%, 89.38%, 80.0%, 91.82% and 87.65% respectively. The incidence of breast cancer in our studied population was 35.5%.

Conclusion: Shear wave elastography is a simple, cost-effective and non-invasive modality that offers improved diagnostic accuracy for identifying malignant breast lesions.