Breast US elastography

Breast cancer continues to be the most common cancer in women. Breast lesions whether malignant or benign, are the target of many diagnostic and screening modalities(1). Breast biopsy, which known widely as the gold standard of breast cancer diagnosis, has many limitations including high rates of benign lesions revealed, some complications like bleeding, hematoma, patient discomfort, pain, and bruising(1-3). Invasiveness of breast biopsy looks for the emergence of other modalities to differentiate between malignant and benign lesions in sooner stages. Radiologic methods such as mammography and ultrasonography initiated a new area in cancer screening and diagnosis. Mammographic criteria especially categorized as BIRADS (Breast Imaging And Data System) classification are used worldwide as a first diagnostic modality for breast lesion detections. In young women (under 40 years) and in cases with dense breasts it has limitation for application (4) Conventional Ultrasound is a useful technique to be joined by biopsy especially in breast with (high scale American College of Radiology classification) dense tissue where mammography does not provide useful information(5, 6). Criteria of malignancy in ultrasound include irregularity of margin, shadowing, echogenicity, microlobulations and shape. Missing small lesions and overestimating lesion size areamong limitations of conventional breast US . Sonoelastography is the new subtype of ultrasound developed in recent couple of years based on tissue’s strain images in response to compression and de-compression of target tissue. (7) Compression and de-compression of target tissue results in local displacements and tissue’s strain images will be obtained. As soft tissue moves easier than hard, the elastogram shows different color which can be scored for breast tissue from 1 to five (8).