Diagnostic Utility of Surrounding Tissue Hardness in Breast Masses: A Quantitative Analysis Using Shear Wave Elastography to Distinguish Malignancy Across Various Mass Sizes.

ABSTRACT

Objective: This study aims to investigate the utility of shear wave elastography (SWE) in quantitatively assessing the surrounding tissue hardness of breast masses and its diagnostic significance in distinguishing between benign and malignant masses of varying sizes. Methods: A retrospective analysis was conducted on 60 patients with breast masses diagnosed at our hospital between January 1, 2022, and December 31, 2022. All patients underwent standard breast ultrasound examination and SWE assessment. Masses were categorized based on diameter (≤20mm and >20mm) for comparative analysis. SWE parameters, including maximum shear wave velocity (Max SWV), mean shear wave velocity (Mean SWV), and elasticity ratio (Eratio) of surrounding tissue, were recorded. Histopathological results determined mass nature. SWE parameters were correlated with pathological diagnoses for discrimination analysis. Results: Of all patients, 37 had benign masses, and 23 had malignant masses. Malignant masses exhibited significantly higher Max SWV, Mean SWV, and Eratio in surrounding tissue compared to benign masses (P < .05). Statistically significant differences in SWE parameters were observed between different-sized masses; smaller masses (≤20mm) showed higher SWE parameters in malignant masses compared to benign masses (P < .05). In masses larger than 20mm, though SWE parameters still differed between benign and malignant masses, the significance was less pronounced (P < .05). Receiver operating characteristic (ROC) analysis demonstrated higher diagnostic accuracy of SWE parameters in discriminating malignancy in smaller breast masses. Conclusions: SWE parameters effectively quantify surrounding tissue hardness in breast masses and have diagnostic value in distinguishing between benign and malignant masses of varying sizes, particularly in masses ≤20mm. SWE offers crucial quantitative parameters for the clinical discrimination of breast masses, enhancing diagnostic accuracy and sensitivity. Future studies should expand sample sizes and optimize diagnostic models to enhance SWE's utility further in discriminating breast mass malignancy.