A systematic program of breast ultrasound screening was carried out in our clinic over a period of more than six years on a large number of women presenting for mammography examination. The aim was to analyze the ability of ultrasound elastography to reduce the number of unnecessary biopsies and to evaluate the overall potential of the technique. Out of more than 16000 patients examined by ultrasound (HI-RTE, Hitachi Medical), 271 breast cancers were detected, 27% of which had not been detected in mammography. An additional examination using ShearWave Elastography (SWE, Supersonic) was performed on 100 lesions found to be neoplastic.
The main contribution of real-time elastography was the increase in confidence that biopsies were not being taken unnecessarily: the use of RTE gave a positive predictive value (PPV) of 75% for a positive biopsy result. The PPV can be increased even further, up to 82%, through use of a secondary, complementary examination using SWE.
This article summarizes our experience of the use of the techniques, their indications and limitations.
By Dr B Scheffer