Additional diagnostic value of shear-wave elastography and color Doppler US for evaluation of breast non-mass lesions detected at B-mode US

To evaluate the diagnostic value of shear-wave elastography (SWE) and colour Doppler ultrasound (US) for evaluation of breast non-mass lesions (NMLs) detected by B-mode US. This retrospective study enrolled 116 NMLs (42 benign, 74 malignant). For each lesion, B-mode US, SWE and colour Doppler US were performed. Mean elasticity (E (mean)), maximum elasticity (E (max)) and vascularity were assessed by SWE and Doppler US. Diagnostic performances of B-mode US, SWE and Doppler US were calculated to differentiate benign and malignant NMLs. In benign NMLs, average E (mean) and E (max) were lower, and low vascularity (no flow or only one vessel flow) was more frequent (P < 0.001). When BI-RADS category 4a NMLs were downgraded to category 3 with 'E (mean) of 85.1 kPa or less' and/or 'low vascularity', specificities increased (69.0-90.5 %; P < 0.001), without significant loss in sensitivities (97.3-100 %). When these 4a NMLs were downgraded by the combination of SWE and Doppler US, all downgraded NMLs (59.3 %, 19/32) were confirmed as benign. Addition of SWE and colour Doppler US to B-mode US improved diagnostic performances in differentiating benign and malignant NMLs. This study suggests that the combination of SWE and colour Doppler may help patients with BI-RADS category 4a NMLs avoid unnecessary biopsies. aEuro cent B-mode US features of malignant and benign NMLs may overlap. aEuro cent SWE and colour Doppler provides useful information about breast NMLs. aEuro cent SWE and colour Doppler may decrease unnecessary biopsies of breast NMLs.