Elastography Helps Reduce Unnecessary Breast Biopsies

Elastography, when added to breast ultrasound, helps distinguish cancerous breast lesions from benign results, according to the results of an ongoing study.

Researchers at Elizabeth Wende Breast Care (Rochester, NY, USA) examined 179 patients who underwent breast ultrasound and elastography. The researchers obtained 184 elastograms and performed biopsies on all solid lesions. The result showed that of 134 biopsies, 56 revealed the presence of cancer. Elastography properly identified 98% of lesions that had malignant findings on biopsy, and 82% of lesions that turned out to be benign. Elastography was also more accurate than ultrasound in gauging the size of the lesions. The study was presented at the annual meeting of the Radiological Society of North America (RSNA), held during November-December 2009 in Chicago (IL, USA).

"You can perform elastography at the same time as handheld ultrasound and view the images on a split screen, with the two-dimensional ultrasound image on the left and the elastography image on the right,” said lead author and study presenter Stamatia Destounis, M.D. "It's an easy way to eliminate needle biopsy for something that's probably benign.”

"With more research, elastography could impact decisions to not perform biopsy in patients [who don't need it],” added Dr. Destounis, who went on to say that currently, 80% of breast biopsies yield benign results. "You still have patients who insist on needle biopsy because they don't want to worry at all. But it's exciting that we are trying to find ways to not perform unnecessary biopsies.”

Elastography is a noninvasive method in which stiffness or strain images of soft tissue are used to detect or classify tumors, since a tumor or a suspicious cancerous growth is normally 5-28 times stiffer than the background of normal soft tissue. Thus, when a mechanical compression or vibration is applied, the tumor deforms less than the surrounding tissue. Ultrasonic imaging is the most common medical imaging technique for producing elastograms.

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