The Value Of Ultrasonic Elastography In The Differential Diagnosis Of Breast Cancer

Objective:1.To evaluate the diagnostic value of ultrasound elastography(UE) in breast cancer.2.To compare the differences of UE,conventional ultrasound (CUS),mammography and UE-CUS of above four methods of identification of benign and malignant tumors of the breast.3. To assess the clinical value of UE between group Ⅰ (the diameter≤2 cm) and group Ⅱ (the diameter>2 cm) in order to get the evidence regarding the ability of screening in small breast cancer.Methods:105 patients with 110 breast lesions were examined by UE, CUS and mammography before surgery from October 2013 to October 2014, and all results were analyzed statistically. Then the total were divided into group Ⅰ (the diameter≤2 cm,n=66) and group Ⅱ (the diameter>2 cm,n=44). To get the clinical value of all the breast lesions in diameter and group Ⅰ,group Ⅱ by UE.Results:1.The pathological result of 110 lesions:62 benign lesions and 48 malignant lesions.2.UE score diagnosis of breast cancer, The sensitivity,specificity,accuracy, positive predictive value and negative predictive value were 91.67%,70.97%,80.00%,70.97%,91.67%, respectively;CUS were:81.25%,74.19%,77.27%,70.91%,83.64%, respectively;The combination imaging were:91.67%,87.10%,89.10%,84.62%,93.10%, respectively; mammography were:77.08%,69.35%,72.73%,66.07%,79.63%, respectively.3.The data of AUC by four methods were 0.874,0.777,0.894,0.732, respectively, which were between 0.7-0.9,The range of above four methods can tell the diagnostic accurany in indentifying benign and malignant breast lesion. Sensitivity:The combination, UE which is diagnosed alone and CUS alone were entirely high, the difference was not statistically significant (P>0.05). Specificity:The combination was higher than the diagnosis,alone. UE and mammography compared respectively had a significant difference(P< 0.05).Accuracy:diagnosis combined was higher than individual, the differences were statistically significant(P<0.05).4. The negative predictive value of UE in the diagnosis of group Ⅰ(the diameter≤2 cm) was 97.22% which was significantly increased than group Ⅱ of the same method(the diameter>2 cm)(P<0.05). Signifincant difference were not found for the remaining indicators(the sensitivity,specificity,accuracy and positive predictive value) of UE (P>0.05).Conclusions:1.UE is a useful supplement to CUS and mammography,UE is a promising technology in diagnosis of breast lesions.2.UE, CUS and mammography in the diagnosis of breast benign and malignant lesions have a certain value,the accuracy of the elasticity score is slightly higher than conventional ultrasound, but the difference was not statistically significant. The combination of UE and CUS can significantly improve the diagnostic accuracy of breast tumor.3.In addition to the negative predictive, The size of the lesion has little effect on sensitivity and specificity of UE in index.