SPJ Publication
Innovative Journal of Medical Imaging
Open Access Original Research

Correlation of Mammographic and Shear Wave Elastography Findings with Histopathology in the Characterization of Breast Lesions: A Retrospective Study

*,

* Corresponding author: Rakshitha K

DOI10.62502/ijmi/v3i3art1
Pages 1–6Language ENLicenceCC BY-NC 4.0 Crossmark XML metadata
  1. Received11 Aug 2026
  2. Accepted15 Sep 2026
  3. Published18 Sep 2026

Abstract

Background: Accurate differentiation of benign and malignant breast lesions remains an important challenge in breast imaging. Shear wave elastography (SWE) provides quantitative assessment of tissue stiffness and may offer complementary information to conventional breast imaging.

Objective: To evaluate the role of quantitative SWE in differentiating benign and malignant breast lesions and to assess its correlation with histopathological findings.

Materials and Methods: A retrospective observational study was conducted in the Department of Radiology and Imaging Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, India, from August 2019 to April 2020. Twenty-three female patients aged 23–88 years with clinically suspected or imaging-detected breast lesions were included. All patients underwent mammography, SWE, and ultrasound-guided 18-gauge core needle biopsy. Lesions were categorized according to BI-RADS, and quantitative elasticity values were recorded in kilopascals (kPa). SWE findings were compared with histopathological diagnoses.

Results: Histopathological examination identified 12 benign lesions (52%) and 11 malignant lesions (48%). The mean elasticity value was 52 kPa in benign lesions, with a range of 13.7–113.5 kPa, compared with 97 kPa in malignant lesions, with a range of 67.6–152.9 kPa. A cutoff value of 97 kPa was identified for differentiating malignant from benign lesions. SWE findings demonstrated a concordance of 95.6% (22/23 cases) with histopathological findings. Higher BI-RADS categories, particularly BI-RADS 4C and 5, were associated with malignancy.

Conclusion: Quantitative SWE demonstrated higher tissue stiffness in malignant breast lesions and showed high concordance with histopathological findings in this study. SWE may serve as a useful adjunct to mammography, conventional ultrasound, and BI-RADS assessment for breast lesion characterization.

Keywords

Breast LesionsShear Wave ElastographyMammographyUltrasoundBI-RADS

References

  1. Freihat O, Sipos D, Kovacs A. Global burden and projections of breast cancer incidence and mortality to 2050: a comprehensive analysis of GLOBOCAN data. Front Public Health. 2025;13:1622954. doi:10.3389/fpubh.2025.1622954. PMID: 41246094.

  2. Chetry M, Feng R, Babar S, Sun H, Zafar I, Mohany M, et al. Early detection and analysis of accurate breast cancer for improved diagnosis using deep supervised learning for enhanced patient outcomes. PeerJ Comput Sci. 2025;11. doi:10.7717/peerj-cs.2784.

  3. Mann RM, Athanasiou A, Baltzer PAT, Camps-Herrero J, Clauser P, Fallenberg EM, et al. Breast cancer screening in women with extremely dense breasts: recommendations of the European Society of Breast Imaging (EUSOBI). Eur Radiol. 2022;32:4036-4050. doi:10.1007/s00330-022-08617-6.

  4. Gordon PB. The impact of dense breasts on the stage of breast cancer at diagnosis: a review and options for supplemental screening. Curr Oncol. 2022;29(5):3595-3636. doi:10.3390/curroncol29050291. PMID: 35621681.

  5. Nazari SS, Mukherjee P. An overview of mammographic density and its association with breast cancer. Breast Cancer. 2018;25(3):259-267. doi:10.1007/s12282-018-0857-5. PMID: 29651637.

  6. Abu Abeelh E, AbuAbeileh Z. Comparative effectiveness of mammography, ultrasound, and MRI in the detection of breast carcinoma in dense breast tissue: a systematic review. Cureus. 2024;16(4). doi:10.7759/cureus.59054.

  7. Iacob R, Iacob ER, Stoicescu ER, Ghenciu DM, Cocolea DM, Constantinescu A, et al. Evaluating the role of breast ultrasound in early detection of breast cancer in low- and middle-income countries: a comprehensive narrative review. Bioengineering (Basel). 2024;11(3):262. doi:10.3390/bioengineering11030262.

  8. Kwon HJ, Shin B. Ultrasound elastography. In: Encyclopedia of Biomedical Engineering. Vol. 1. 2019. p. 604-613. doi:10.1016/B978-0-12-801238-3.99951-3.

  9. Youk JH, Gweon HM, Son EJ. Shear-wave elastography in breast ultrasonography: the state of the art. Ultrasonography. 2017;36(4):300-309. doi:10.14366/usg.17024.

  10. Mahmoud ZMS, El-Shinnawy MAM, Ali NSAA. Diagnostic role of shear wave elastography in differentiating benign from malignant breast masses. Egypt J Radiol Nucl Med. 2025;56:1-11. doi:10.1186/s43055-025-01548-4.

  11. Selim YAY, Sabit H, Arneth B, Shaaban MA. Diagnostic accuracy of sonoelastography for breast lesions: a meta-analysis comparing strain and shear wave elastography. J Imaging. 2025;11(7):221. doi:10.3390/jimaging11070221.

  12. Rajbongshi H, Gogoi M, Goswami S, Duara BK. Diagnostic role of shear wave elastography for differentiating benign and malignant breast lesions with histopathological examination (HPE) correlation. Cureus. 2026;18(2). doi:10.7759/cureus.104103.

  13. Ng WL, Rahmat K, Fadzli F, Rozalli FI, Mohd-Shah MN, Chandran PA, et al. Shearwave elastography increases diagnostic accuracy in characterization of breast lesions. Medicine (Baltimore). 2016;95(12). doi:10.1097/MD.0000000000003146. PMID: 27015196.

  14. Farooq F, Mubarak S, Shaukat S, Khan N, Jafar K, Mahmood T, et al. Value of elastography in differentiating benign from malignant breast lesions keeping histopathology as gold standard. Cureus. 2019;11(10). doi:10.7759/cureus.5861.

  15. Shahzad R, Fatima I, Anjum T, Shahid A. Diagnostic value of strain elastography and shear wave elastography in differentiating benign and malignant breast lesions. Ann Saudi Med. 2022;42(5):319-326. doi:10.5144/0256-4947.2022.319. PMID: 36252146.