IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 20, Issue 6 Ser.5 (June. 2021), PP 20-31 www.iosrjournals.org DOI: 10.9790/0853-2006052031 www.iosrjournal.org 20 | Page Role of Elastography in the Assessment of Benign and Malignant Breast Lesions with Histopathological Corelation - A Prospective Study Dr. Nupur Basu 1 , Dr. Kosturi Dakshit 2 , Dr. Debashis Dakshit 3 , Dr. Arup Maity 4 1 (Associate Professor, Department of Radio-diagnosis, Medical College and Hospital, Kolkata) 2 (Junior Resident, Department of Community Medicine, SJS Medical College and KEM Hospital, Mumbai ) 3 (Professor & HOD, Department of Radio-diagnosis, Medical College and Hospital, Kolkata) 4 (Junior Resident, Department of Radio-diagnosis, Medical College and Hospital, Kolkata) Abstract: Background: Breast Cancer is the most common cancer in females, both in developed and developing countries and its incidence continues to escalate. Therefore, early detection to improve breast cancer outcomes remains the cornerstone of breast cancer control. Guidelines recommend screening for detecting breast cancer with mammography and ultrasonography. Strain elastography is a newer technique that can aid additional characterization of breast lesions. Objective: The aim of this study was to determine the diagnostic accuracy of breast ultrasound elastography in differentiating benign from malignant breast lesions using histopathological diagnosis as gold standard. Materials and Methods: The study was conducted at Department of Radio-Diagnosis, Medical College Kolkata. A total of 48 patients with breast lump were examined with B-mode sonography and subsequently with elastography. The study was conducted from 1 st August 2020 to 31 st January 2021. Conventional sonographic findings were classified according to the American College of Radiology Breast Imaging Reporting and Data System for sonography, and elastography images were assigned an elasticity score of 1 to 5 (1-3, benign; 4 and 5, malignant) according to the Ueno classification. Cytologic diagnoses obtained from fine-needle aspiration and histopathologic results from a core-needle biopsy or surgical biopsy were used as reference standards. Statistical analysis included sensitivity, specificity, and positive and negative predictive values. Results: A total of 48 patients were included with a mean age of 36.7 years (range 17-61 years). On histopathological evaluation, 11(18.7%) lesions were malignant and 37(81.3%) were benign. Strain Elastography had sensitivity of 72.7% (95% confidence interval), specificity of 94.5%, a positive predictive value of 80% and a negative predictive value of 92.1% with an accuracy of 89.5%. Conclusion: Our results show that elastography may be useful as a complementary technique in addition to conventional sonography in the characterization of breast lesions because it increases the diagnostic specificity, thus reducing the false-positive rate. Use of elastography may increase malignancy detection rate by reducing the need for biopsy in benign breast lesions. Key word: Sonoelastography (SE); Breast Cancer; Ultrasound; Benign and malignant breast lesions --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 30-05-2021 Date of Acceptance: 13-06-2021 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction The rising incidence of breast cancer has led to tremendous research and innovations with consequent development of new diagnostic techniques. The recent development of breast ultrasound elastography (USE) has produced promising results in early diagnosis and differentiation of breast lesions. USE differentiates between benign and malignant lesions on the basis of elasticity of tissues with benign lesions having elasticity similar to adjoining normal tissues, while malignant lesions (being harder clinically) have lower elasticity as compared to adjoining normal tissues. In comparison, malignant tissues which have lower elasticity, display larger diameter in USE as compared to the B-mode sonography due to local infiltration and desmoplastic reaction. The purpose of this study was to evaluate the role of USE in the early diagnosis and differentiation of breast masses. Benign tissues appear similar to surrounding tissues and display smaller diameter on elastography. II. Review of Literature Ultrasound elastography is a new imaging mode that display tissue stiffness or hardness in real time as a colour map that translucently overlays the conventional B-mode image. The technique significantly improves