Crombé Amandine, Hurtevent-Labrot Gabrielle, Asad-Syed Maryam, Palussière Jean, MacGrogan Gaetan, Kind Michèle, Ferron Stéphane
1 Department of Radiology,Institut Bergonié, Comprehensive cancer centre , Institut Bergonié, Comprehensive cancer centre , Bordeaux , France.
2 Department of Pathology,Institut Bergonié, Comprehensive cancer centre , Institut Bergonié, Comprehensive cancer centre , Bordeaux , France.
Br J Radiol. 2018 Feb;91(1082):20170676. doi: 10.1259/bjr.20170676. Epub 2017 Dec 5.
To evaluate the ability of shear-wave elastography (SWE) to distinguish between benign and malignant palpable masses of the adult male breast.
Clinical examination, mammography, B-mode and Doppler ultrasound findings and SWE quantitative parameters were compared in 50 benign lesions (including 40 gynaecomastias) and 15 malignant lesions (invasive ductal carcinomas) from 65 patients who were consecutively addressed for specialized advice at our comprehensive cancer centre. Mean elasticity (El mean), maximum elasticity (El max), El mean of the surrounding fatty tissue and lesion to fat ratio (El ratio) were reported for each patient.
Malignant masses displayed significantly higher El mean (p < 0.0001), El max (p < 0.0001) and El ratio (p < 0.0001) compared to benign masses without overlap of values between the two groups. By adding SWE to clinical examination, mammography and ultrasound, all the lesions would have been retrospectively correctly diagnosed as benign or malignant. One false positive could have been downstaged, 14/65 undetermined masses could have been correctly reclassified as 4 malignant and 10 benign lesions, for which biopsies could have consequently been avoided.
Evaluation of male breast palpable masses by SWE demonstrates that malignant masses are significantly stiffer lesions and may improve diagnostic management when clinical examination, mammography and conventional ultrasound are doubtful. Advances in knowledge: Quantitative SWE is feasible in male breast and could be of great interest to help classify doubtful lesions after classical clinical and radiological evaluations, probably because of different anatomy and different tumours epidemiology compared with female breast.
评估剪切波弹性成像（SWE）区分成年男性乳腺可触及的良性和恶性肿块的能力。
对在我们综合癌症中心连续寻求专业建议的65例患者的50个良性病变（包括40例男性乳房发育症）和15个恶性病变（浸润性导管癌）的临床检查、乳腺X线摄影、B超和多普勒超声检查结果以及SWE定量参数进行了比较。报告了每位患者的平均弹性（El均值）、最大弹性（El最大值）、周围脂肪组织的El均值以及病变与脂肪比率（El比率）。
与良性肿块相比，恶性肿块的El均值（p < 0.0001）、El最大值（p < 0.0001）和El比率（p < 0.0001）显著更高，两组之间的值无重叠。通过将SWE添加到临床检查、乳腺X线摄影和超声检查中，所有病变都可以被回顾性地正确诊断为良性或恶性。1例假阳性结果可能被降级，65个未确定的肿块中有14个可以被正确重新分类为4个恶性病变和10个良性病变，从而可以避免进行活检。
通过SWE评估男性乳腺可触及的肿块表明，恶性肿块是明显更硬的病变，当临床检查、乳腺X线摄影和传统超声检查结果存疑时，可能会改善诊断管理。知识进展：定量SWE在男性乳腺中是可行的，在经典临床和放射学评估后，可能由于与女性乳腺不同的解剖结构和不同的肿瘤流行病学，有助于对可疑病变进行分类，这可能会引起极大关注。
