Diagnostic Accuracy of Shear Wave Elastography in the Evaluation of Solid Breast Lesions, Taking Histopathology as the Gold Standard: Shear Wave Elastography in Solid Breast Lesions: Histopathology as the Gold Standard

Fariha Mumtaz; Kamran Naseem; Syed Saad Gardezi; Nazish Butt; Bushra Nisar; Rab Nawaz Malik

doi:10.54393/pjhs.v7i1.3510

Authors

Fariha Mumtaz Department of Radiology, Bahawal Victoria Hospital, Bahawalpur, Pakistan
Kamran Naseem Department of Radiology, Bahawal Victoria Hospital, Bahawalpur, Pakistan
Syed Saad Gardezi Department of Histopathology, Quaid-e-Azam Medical College, Bahawalpur, Pakistan
Nazish Butt Department of Radiology, Shahida Islam Medical Complex, Lodhran, Pakistan
Bushra Nisar Department of Histopathology, Ameer-ud-Din Medical College, Lahore, Pakistan
Rab Nawaz Malik Department of Surgery, Buch International Hospital, Multan, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v7i1.3510

Keywords:

Shear Wave Elastography, Breast Cancer, Solid Breast Lesions, Diagnostic Accuracy, Histopathology, Ultrasound

Abstract

Breast cancer is the most common malignancy among women worldwide and a leading cause of cancer-related mortality in Pakistan. Accurate differentiation between benign and malignant solid breast lesions is essential for appropriate management. Conventional B-mode ultrasonography is widely used but is limited by operator dependence. Shear wave elastography (SWE) provides an objective, quantitative assessment of tissue stiffness and may improve diagnostic accuracy. Objectives: To evaluate the diagnostic accuracy of shear wave elastography in differentiating benign and malignant solid breast lesions using histopathology as the reference standard. Methods: This descriptive cross-sectional study was conducted at the Department of Radiology, Bahawal Victoria Hospital, Bahawalpur, from March to September 2023. A total of 232 patients with solid breast lesions detected on ultrasound underwent SWE followed by core needle biopsy or surgical excision. Mean elasticity (Emean), maximum elasticity (Emax), and lesion-to-parenchyma elasticity ratio were recorded. Diagnostic performance was assessed using receiver operating characteristic analysis. Results: Among 232 lesions, 153 (65.9%) were benign and 79 (34.1%) were malignant. Malignant lesions showed significantly higher SWE values (p<0.001). AUCs were 0.974 for Emean, 0.986 for Emax, and 0.980 for the elasticity ratio. Emax demonstrated the highest accuracy, with 96% sensitivity and 92% specificity at a cutoff of 130–135 kPa. Conclusions: Shear wave elastography shows excellent accuracy for differentiating solid breast lesions, with Emax being the most reliable parameter.

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