Breast carcinomas: variations in sonoelastographic appearance

Abstract

Eduardo de Faria Castro Fleury,1 Maria do Carmo Guedes Alcoforado Assunção-Queiros,2 Decio Roveda Jr1 1Faculdade de Cências Médicas da Santa Casa de São Paulo, São Paulo, Brazil; 2Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil Background: This study assessed factors influencing the sonoelastographic presentation of breast carcinoma. Methods: A prospective collaborative study was conducted by the Santa Casa de São Paulo and CTC-Center, on 540 breast lesions in women referred for percutaneous breast biopsy. Eighty-four carcinomas showing lesions on ultrasonography were included. These lesions were classified into four sonoelastographic scores, where scores of 1, 2, and 3 were considered false-negative, and a score of 4 was considered true-positive. Scores were compared against histopathologic results, which were divided into two groups, ie, soft lesions (group 1) and hard lesions (group 2). False-negative and true-positive results were also assessed for variation according to patient age and mean lesion diameter. Results: Of the 84 lesions studied, nine yielded false-negative results on sonoelastography and 75 yielded true-positive results. In terms of histopathologic classification, eight were assigned to group 1 and 76 to group 2. The chi-squared test showed a correlation between sonoelastographic scores and histopathologic lesion type. No statistically significant differences were observed according to patient age or largest lesion diameter. Conclusion: Our results revealed an association between sonoelastographic presentation of breast lesions and histology. False-negative results on sonoelastography were influenced by histologic type of lesion and not by lesion size or patient age. Keywords: ultrasound, breast, carcinoma, elastography