Diagnostic Accuracy of Elastography in Diagnosing Breast Cancer, taking Histopathology as Gold Standard

Abstract

Objective: To determine the diagnostic accuracy of breast ultrasound elastography for detecting breast cancer, using histopathology as the gold standard.

Methodology: This cross-sectional diagnostic accuracy study was conducted from February to August 2022 in the Department of Radiology at LUMHS, Hyderabad. Women aged 18–60 years presenting with mastalgia or a palpable breast lump suspicious for malignancy were included. All participants underwent breast ultrasound elastography, and the findings were classified as benign or malignant using the five-point Tsukuba scoring system. Histopathological examination of specimens obtained through ultrasound-guided core needle biopsy or surgical excision served as the gold standard. Diagnostic accuracy was assessed by calculating sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Data were analyzed using SPSS version 25.

Results: A total of 206 women were included, with a mean age of 47.66 ± 8.98 years. Of these, 52 (25.20%) were menstruating, while 154 (74.80%) were menopausal. Using histopathology as the gold standard, elastography demonstrated a sensitivity of 83.01%, specificity of 75.47%, PPV of 90.71%, NPV of 60.61%, and overall diagnostic accuracy of 81.07%.

Conclusion: Breast ultrasound elastography demonstrated promising diagnostic performance in evaluating women with breast lesions suspicious for malignancy. Its relatively high sensitivity and PPV suggest that it may be a useful adjunct to conventional breast imaging; however, histopathological examination remains essential for definitive diagnosis.