背景和目的:乳腺癌是全球女性人群中最常见的癌症之一,如果早期诊断,乳腺癌是可以治愈的。因此,在过去的几十年中,乳腺癌筛查成像技术有了很大的发展和调整.除了乳房X线照相术,超声弹性成像成为乳腺癌检测的重要工具。然而,超声弹性成像仍然有其局限性,即,在BIRADS4类别中,假阳性结果的发生率仍然很高。我们研究的目的是确定潜在的假阳性预测因子,并确定影响应变超声弹性成像质量的因素,以评估分类为BIRADS4B的可疑实性乳腺病变。4C,和5.材料和方法:我们在2017年1月至2022年1月期间在蒂米什瓦拉的一家私人医疗中心进行了一项回顾性研究,使用标准化的BIRADS-US词典通过超声弹性描记术分析了1625个实性乳腺病变。结果:我们的研究表明,大多数与错误和过度诊断相关的超声弹性成像因素是由于结节尺寸(OR=1.02每单位增加)。后声阴影(OR=12.26),反应性腺病(OR=6.35),TES评分增加(TES3OR=6.60;TES4OR=23.02;TES5OR=108.24)。关于患者特征,年龄(OR=每单位增加1.09),BMI,(OR=每单位增加1.09),观察到母乳喂养史(OR=3.00)增加了假阳性结果的可能性.另一方面,不太可能是假阳性组的一部分的结节表现出以下特征:规则形状(OR=0.27),均匀稠度(OR=0.42),和无血管性(OR=0.22)。结论:年龄较大,高BMI,有母乳喂养史的患者,那些表现出以下特定结节特征的人最经常与假阳性结果有关:具有后部声阴影和高弹性评分的大肿瘤,伴有反应性腺病。另一方面,同质,形态规则的无血管结节不易误诊。
Background and Objectives: Breast cancer is one of the most widespread cancers among the female population around the world and is curable if diagnosed in an early stage. Consequently, breast cancer screening imaging techniques have greatly evolved and adjusted over the last decades. Alongside mammography, sonoelastography became an important tool for breast cancer detection. However, sonoelastography still has its limitations, namely, there is still a high occurrence of false positive results in the BIRADS 4 category. The aim of our study is to identify potential false positive predictors and to ascertain the factors influencing the quality of strain ultrasound elastography for the evaluation of suspicious solid breast lesions categorized as BIRADS 4B, 4C, and 5. Materials and Methods: We conducted a retrospective study in a single private medical center in Timisoara between January 2017 and January 2022 analyzing 1625 solid breast lesions by the sonoelastography strain using a standardized BIRADS-US lexicon. Results: Our study showed that most sonoelastography factors linked to incorrect and overdiagnosis were due to a nodule dimension (OR = 1.02 per unit increase), posterior acoustic shadowing (OR = 12.26), reactive adenopathy (OR = 6.35), and an increased TES score (TES3 OR = 6.60; TES4 OR = 23.02; TES5 OR = 108.24). Regarding patient characteristics, age (OR = 1.09 per unit increase), BMI, (OR = 1.09 per unit increase), and breastfeeding history (OR = 3.00) were observed to increase the likelihood of false positive results. On the other hand, the nodules less likely to be part of the false positive group exhibited the following characteristics: a regular shape (OR = 0.27), homogenous consistency (OR = 0.42), and avascularity (OR = 0.22). Conclusions: Older age, high BMI, patients with a breastfeeding history, and those who exhibit the following specific nodule characteristics were most often linked to false positive results: large tumors with posterior acoustic shadowing and high elasticity scores, accompanied by reactive adenopathy. On the other hand, homogenous, avascular nodules with regular shapes were less likely to be misdiagnosed.