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Aim of the workTo detect the diagnostic performance of the combined use of sonoelastographic scoring and strain ratio in differentiation of benign and malignant breast masses with the histopathology is the standard reference.Patients and methodsOne hundred and seventy-two women with 190 breast masses were enrolled in this prospective study. Conventional US (B-mode and color Doppler US) and sonoelastography (elasticity score “ES” and calculation of strain ratio “SR”) were performed. B-mode images were classified according to the Breast Imaging Recording and Data System. The hardness was determined with 5-point scoring method and SRs of the lesions were calculated. Receiver operating characteristic (ROC) curves were performed and the cutoff point for differentiation of benign and malignant masses was detected.ResultsThere was a significant difference (P=0.02) in the mean SRs between benign and malignant breast masses. The area under the curve (AUC) for combination of ES and SR (0.964) was higher than for ES alone (0.852) and B-mode US (0.823). A cutoff value of 3.6 for the SR allowed the best differentiation of benign and malignant breast lesions.ConclusionThe combined use of elasticity score and strain ratio of sonoelastography increased the diagnostic performance in distinguishing benign from malignant breast masses

Combined sonoelastographic scoring and strain ratio in evaluation of breast masses