Adding Special Analysis to Breast Ultrasound Might Help Decide if Mass Is Cancerous

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A small study suggests that adding a special analysis -- called elastography -- to breast ultrasound can help doctors decide if a breast mass is cancer and needs to be biopsied.

If a breast mass shows up on a mammogram, doctors often do a breast ultrasound to help them see other characteristics of the mass -- how solid it is or whether it has fluid in it, for example -- that show better in an ultrasound. Having all this information can help doctors decide if the mass is cancer and if a biopsy makes sense. If the mass appears to be benign (not cancer) based on the ultrasound, careful monitoring of the mass without a biopsy could make sense.

A breast biopsy is an invasive procedure, so doctors only want to do it when it's necessary. The researchers who did this study estimated that 80% of biopsied breast masses turn out to be benign. Having a better way to figure out if a mass is likely to be cancer could help women avoid unnecessary biopsies.

Elastography uses a computer program to analyze ultrasound images of a breast mass and judge how stiff the mass is. An ultrasound done with elastography is no different than that one done without elastography. Masses that are cancer tend to be stiffer than the surrounding healthy breast tissue. The elastography software judges stiffness of a mass by detecting how much the mass does or doesn't get compressed by the pressure of breathing, heart beats, or by pushing on the chest wall.

All the masses in this study were biopsied.

The researchers found:

  • 59 of masses were cancer; elastography correctly identified 58 (98%) of these as cancer.
  • 69 of the masses weren't cancer; elastography correctly identified 54 (78%) of these as benign. Elastography identified the other 15 masses as cancer even though they were not cancer.

These results suggest that elastography is better at judging when a mass is cancer than it is at judging when a mass is benign.

Elastography software isn't new, but hasn't been used very much to help diagnose breast cancer. The results of this study suggest that using elastography more often during breast ultrasound could help doctors decide if a breast mass should be biopsied and help avoid some unnecessary breast biopsies.

The Breastcancer.org Ultrasound page has more information about when and how breast ultrasound in done and how the results help doctors diagnose benign and cancerous breast masses.

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