Ultrasound Technology Helps Identify Patients Who Need Breast Biopsies

A new ultrasound technique is proving beneficial in differentiating malignant from benign breast lesions in some patients--results that could mean fewer unnecessary breast biopsies, a new study revealed.

The study found that ultrasound elastography, which indicates tissue softness, could help predict cancer in patients with BI-RADS (Breast Imaging-Reporting and Data System) category 4 masses. "Because malignant tumors predominantly are harder than benign tissues, this technique significantly improves the differentiation between benign and malignant tissue,” said Hiroko Satake, M.D., lead author of the study. Dr. Satake is from Nagoya University School of Medicine (Nagoya, Japan). "In an analysis of 115 breast masses that were recommended for biopsy [they were categorized as either BI-RADS 4 or BI-RADS 5], ultrasound elastography was 79% accurate in identifying cancer.”

Ultrasound elastography provides radiologists with elasticity scores, with lower scores meaning that the mass contains softer tissue. "By accurately identifying benign tumors with imaging, we may be able to avoid sending patients for unnecessary biopsies. Based on the results of our study, we recommend that patients with BI-RADS 4 masses should undergo biopsy if their ultrasound elasticity score is 4 or 5,” Dr. Satake said.

Dr. Satake noted that ultrasound elastography should be used as an adjunct to conventional sonography and dynamic contrast-enhanced magnetic resonance imaging (MRI), which are currently being used to classify breast lesions based on the standard BI-RADS categorizations.

The study was published in the January 2011 issue of the American Journal of Roentgenology.

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Nagoya University School of Medicine