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The differential diagnosis of benign and malignant breast cancer using shear wave elastography (SWE)

Baohua Wang, Zhenyu Cai, Ying Hu, Jing Wang, Yanhua Chu, Tian'an Jiang, Jing Cheng, Shusen Zheng

The purpose of our study is to explore the efficiency of Shear Wave Elastography (SWE) in predicting malignancy Breast Cancer (BC). 63 patients with normal mammary glands and 61 patients with invasive carcinoma were detected by Real-time Tissue Elastography (RTE). Two SWE images of breast hyperplasia with fibroadenoma and invasive breast carcinoma were also obtained. For the SWE characteristics, maximum, minimum, mean elasticity and SWE ratio were acquired. The SWE ratio was counted to reflect the stiffness of lesions, and a high ratio demonstrated a stiff lesion. Kruskal-Wallis one-way ANOVA, Receiver Operating Characteristic (ROC) curve, and Z-Test were used for statistical analysis. Our results indicated that SWE in patients with normal mammary glands showed a light-blue coloured lesion and the SWE values (E_mean) was 7.1 kPa. SWE in patients with invasive carcinoma revealed a yellow-to-red coloured mass, and the SWE values (E_mean) was 243.6 kPa. The cut-off values of the ROC curve analysis at lesion (E_max) and gland ratio (E_rat) were 55.8 kpa and 3.45. The Z value was 0.915, and the P value was 0.36 for ROC curve between E_max and E_rat. The SWE value (E_mean) in front of the fat layer was 12.6 kPa in patients with breast hyperplasia accompanying fibroadenoma. The SWE values (E_mean) in front of the fat layer was 23.9 kPa in patients with invasive carcinoma. Breast cancers with invasive characteristics had high SWE ratios. Therefore, SWE may provide potential application value for predicting prognosis.