Ultrasound elastograms help identify breast cancers

CHICAGO (Reuters) - Software that helps determine the stiffness of a breast lump may help some women avoid unnecessary biopsies, U.S. researchers said on Monday at the Radiological Society of North America meeting in Chicago.

They said the technique, called elastography, which is used in tandem with standard ultrasonography, correctly identified 98% of breast cancers in their study.

It also correctly ruled out breast cancer in 78% of women whose lumps were later found to be harmless, Dr. Stamatia Destounis of Elizabeth Wende Breast Care in Rochester, New York told reporters.

"The addition of elastography could potentially help decrease the need to perform a biopsy or could reduce the need for additional imaging, thus reducing the anxiety and stress on the patient and also the financial hardship that unnecessary biopsy procedures may cause," Dr. Destounis told the meeting.

That might help ease some of the concerns about routine mammography screening, which can result in excess biopsies, especially in women who get regular mammograms starting at age 40.

The U.S. Preventive Services Task Force earlier this month recommended against routine mammograms for women in their 40s to spare them from some of the worry and expense of extra tests to rule out cancer.

Often, when mammography is inconclusive, women are referred for ultrasonography.

"The problem with ultrasound is that it is very sensitive. It will find it for us, but it is not specific enough. It doesn't tell us if that is a benign lesion or a cancerous lesion," Dr. Destounis said.

She said many ultrasound machines have elastography software, which can measure the stiffness of a breast lump.

"The premise is that a malignant tumor will be stiffer than the surrounding normal breast tissue," Dr. Destounis said.

At the meeting, she reported on the effectiveness of ultrasonography with elastography in 193 women aged 18 to 92 with a total of 198 lesions.

Fifty-eight lesions did not require a biopsy.

Of the 140 biopsies, 59 revealed cancers. The elastogram software was 98% accurate at identifying cancers and 78% accurate at identifying benign lesions, but in some cases it did produce false-positive results.

Dr. Destounis said imaging companies are refining elastogram software to make the programs even more accurate.

"We believe...elastography could in the near future impact the decision to not perform a biopsy in some of these benign patients," she said.

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