EVALUATION OF SOLID BREAST MASSES BY SHEAR WAVE ELASTOGRAPHY KEEPING BIOPSY AS GOLD STANDARD

Abstract

Objective: To determine the diagnostic accuracy of shear wave elastography in evaluation of solid breast masses using biopsy as the gold standard.

Methodology: This cross-sectional validation study was conducted at the Department of Radiology, Shaikh Zayed Hospital, Lahore,from April 2025 to July 2025,  including 196 women with solid breast masses. Shear wave elastography was performed using the Aixplorer multiwave ultrasound system, and lesions were categorized as benign or malignant. Ultrasound-guided core needle biopsy was performed for histopathological confirmation as the gold standard.

Results: The mean age was 42.6 ± 10.8 years. On biopsy, 68 (34.7%) lesions were malignant and 128 (65.3%) were benign. Shear wave elastography identified 60 true positives, 114 true negatives, 14 false positives, and 8 false negatives. Sensitivity was 88.2%, specificity 89.1%, positive predictive value 81.1%, negative predictive value 93.4%, and diagnostic accuracy 88.8%. Malignant lesions demonstrated significantly greater stiffness compared with benign lesions (p<0.001).

Conclusion: Shear wave elastography demonstrated high diagnostic accuracy in differentiating benign from malignant solid breast masses and may serve as a reliable adjunctive tool in breast imaging using biopsy as the reference standard.