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Shear wave elastography in the diagnosis of breast non-mass lesions: factors associated with false negative and false positive results

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To investigate factors related to false shear wave elastography (SWE) results for breast non-mass lesions (NMLs) detected by B-mode US.


This retrospective study enrolled 152 NMLs detected by B-mode US and later pathologically confirmed (79 malignant, 73 benign). All lesions underwent B-mode US and SWE. Quantitative (mean elasticity [E mean]) and qualitative (maximum stiffness colour) SWE parameters were assessed, and ‘E mean > 85.1 kPa’ or ‘stiff colour (green to red)’ determined malignancy. Final SWE results were matched to pathology results. Multivariate logistic regression analysis identified factors associated with false SWE results for diagnosis of breast NMLs.


Associated calcifications (E mean: odds ratio [OR] = 7.60, P < 0.01; maximum stiffness colour: OR = 6.30, P = 0.02), in situ cancer compared to invasive cancer (maximum stiffness colour: OR = 5.29, P = 0.02), and lesion size (E mean: OR = 0.90, P < 0.01; maximum stiffness colour: OR = 0.91, P = 0.01) were significantly associated with false negative SWE results for malignant NMLs. Distance from the nipple (E mean: OR = 0.84, P = 0.03; maximum stiffness colour: OR = 0.93, P = 0.04) was significantly associated with false positive SWE results for benign NMLs.


Presence of associated calcifications, absence of the invasive component, and smaller lesion size for malignant NMLs and shorter distance from the nipple for benign NMLs are factors significantly associated with false SWE results.

Key points

Calcification and size are associated with false negative SWE in malignant NMLs.

In situ cancer is associated with false negative SWE in malignant NMLs.

Distance from the nipple is associated with false positive SWE in benign NMLs.

These factors need consideration when performing SWE on breast NMLs.

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Fig. 1
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E max :

Maximum elasticity

E mean :

Mean elasticity


Non-mass lesion


Odds ratio


Shear wave elastography




US-guided core needle biopsy


Ultrasonographic elastography


US-guided vacuum-assisted biopsy


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Correspondence to Ji Soo Choi.

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The scientific guarantor of this publication is Boo-Kyung Han.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.


The authors state that this work has not received any funding.

Statistics and biometry

No complex statistical methods were necessary for this paper.

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Institutional review board approval was obtained.

Informed consent

Written informed consent was waived by the institutional review board.

Study subjects or cohorts overlap

Any study subjects or cohorts have not been previously reported


• retrospective

• diagnostic or prognostic study

• performed at one institution

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Park, S.Y., Choi, J.S., Han, BK. et al. Shear wave elastography in the diagnosis of breast non-mass lesions: factors associated with false negative and false positive results. Eur Radiol 27, 3788–3798 (2017).

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