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Role of sonoelastography in characterising breast nodules. Preliminary experience with 120 lesions

Ruolo dell’elastosonografia nella caratterizzazione dei noduli mammari. Esperienza preliminare su 120 lesioni

  • Breast Radiology/Senologia
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

This study was performed to evaluate the diagnostic accuracy of sonoelastography in differentiating and characterising nodular breast lesions.

Materials and methods

A total of 120 nodular lesions diagnosed on mammography and/or ultrasonography in 110 women (mean age 51.27 years) were evaluated with sonoelastography and classified according to elasticity score (S1–S5). Needle biopsy was performed in 104/120 cases, whereas 16/120 were sent for follow-up. Sensitivity and specificity of sonoelastography were determined by taking biopsy findings as the gold standard.

Results

Biopsy yielded the following results: 66 benign, three equivocal and 35 malignant lesions. Sensitivity and specificity of sonoelastography were, respectively, 88.5% and 92.7%. All nodules with an elasticity score of 5 were malignant, and those with a score ≤3 were benign, with the exception of four cases of invasive carcinoma with atypical elasticity (two lobular and two ductal with liquefaction necrosis). Twenty-two lesions were scored 4: 17 were malignant, two equivocal (columnar cell hyperplasia and complex sclerosing lesion) and three benign (sclerotic fibroadenomas).

Conclusions

The use of sonoelastography to complement mammography and ultrasonography could help in the differential diagnosis of nodular breast lesions, especially in Breast Imaging Reporting Data System (BI-RADS) 3 lesions with marked elasticity (S≤3). In these cases, the high concordance between elastography and cytology or histology in diagnosing benign lesions could reduce the number of needle biopsies and guide women at low radiological risk towards follow-up.

Riassunto

Obiettivo

Valutare l’accuratezza dell’elastosonografia nella differenziazione e caratterizzazione dei noduli mammari.

Materiali e metodi

Valutazione con elastosonografia di 120 lesioni nodulari (classificate con score elastico (S1–S5) diagnosticate mammograficamente e/o ecograficamente in 110 donne (età media 51,27 anni). Sono state sottoposte ad agobiopsia 104/120 lesioni, mentre in 16/120 casi e stato scelto il follow-up. La sensibilità e la specificità dell’elastosonografia sono state calcolate assumendo i risultati anatomopatologici come gold standard.

Risultati

L’esito dei 104 prelievi è stato: 66 benigni, 3 dubbi, 35 maligni. La sensibilità e specificità dell’elastosonografia sono risultate rispettivamente del 88,5% e del 92,7%. Tutti i noduli S5 sono risultati maligni mentre quelli con S≤3 sono tutti risultati benigni, eccetto quattro casi di carcinomi infiltranti con elasticità atipica (2 lobulari e 2 duttali con necrosi colliquativa). Le 22 lesioni S4 sono risultate: 17 maligne, 2 dubbie (iperplasia a cellule colonnari e lesione sclerosante complessa), 3 benigne (fibroadenomi sclerotici).

Conclusioni

L’elastosonografia utilizzata come metodica complementare alla mammografia ed all’ecografia consente un’accurata diagnosi differenziale dei noduli mammari, specialmente nelle lesioni Breast Imaging Reporting Data System (BI-RADS) 3 dotate di elevata elasticità (S≤3). L’alta concordanza tra le caratteristiche elastiche ed il riscontro anatomopatologico di benignità potrebbe evitare il prelievo agobioptico indirizzando verso il follow-up nei casi con basso rischio radiologico.

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Authors and Affiliations

  1. Istituto di Radiologia Diagnostica ed Interventistica, Università di Torino, ASO San Giovanni Battista di Torino, Sede Molinette, Via Genova 3, 10126, Torino, Italy

    E. Regini, S. Bagnera, D. Tota, P. Campanino, A. Luparia, F. Barisone, M. Durando, G. Mariscotti & G. Gandini

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  1. E. Regini
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  2. S. Bagnera
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  3. D. Tota
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  4. P. Campanino
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  5. A. Luparia
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  6. F. Barisone
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  7. M. Durando
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  8. G. Mariscotti
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  9. G. Gandini
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Correspondence to E. Regini.

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Regini, E., Bagnera, S., Tota, D. et al. Role of sonoelastography in characterising breast nodules. Preliminary experience with 120 lesions. Radiol med 115, 551–562 (2010). https://doi.org/10.1007/s11547-010-0518-z

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  • DOI: https://doi.org/10.1007/s11547-010-0518-z

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