Breast and Axilla Imaging: Traditional Ultrasound vs. Shear Wave Elastography

Breast cancer remains a significant global health concern, emphasizing the need for accurate diagnostic tools. In recent years, advancements in ultrasound technology have led to the emergence of shear wave elastography (SWE) as a valuable imaging technique. In this article, we’ll delve into the differences between traditional ultrasound scans and SWE, along with their respective advantages.

Traditional Ultrasound Scans

1. Focus on Anatomy:
   • Traditional ultrasound primarily visualizes breast tissue anatomy, providing essential information about tissue structure, masses, cysts, and architectural distortions.
   • However, it has limitations in precisely characterizing tissue stiffness.
2. Morphology Assessment:
   • Benign axillary lymph nodes on mammography appear oval in shape, typically measuring less than 2 cm, with a preserved fatty hilum (radiolucent notch).
   • Increased lymph node size or density can be abnormal and requires further evaluation¹.
3. Ultrasound Evaluation:
   • On ultrasound, normal axillary lymph nodes exhibit an oval or lobulated shape with a preserved fatty hilum and cortical thickness less than 3 mm.
   • Features concerning for malignancy include round shape, increased cortical thickness, and loss of fatty hilum.
   • Cortical thickening is considered an early morphologic change associated with malignancy, while absent/replaced hilum is highly specific for malignancy¹.

Shear Wave Elastography (SWE)

1. Beyond Anatomy:
   • SWE assesses tissue stiffness by measuring the speed of shear waves propagating through tissues.
   • It provides quantitative data, including numerical values (in kilopascals), representing tissue elasticity.
2. Advantages of SWE:
   • Quantitative Assessment:
     • SWE offers objective measurements of tissue stiffness, enhancing diagnostic accuracy.
     • Radiologists can compare stiffness values between different regions of interest within the breast.
   • Improved Specificity:
     • Malignant tumors tend to be stiffer than benign lesions, aiding in differentiation.
   • Reduced False Positives:
     • By improving specificity, SWE reduces unnecessary biopsies.
   • Clinical Decision Support:
     • SWE assists clinicians in making informed decisions about patient care.
3. Clinical Applications:
   • SWE is valuable for assessing breast lesions, axillary lymph nodes, and postoperative scars.
   • It aids in characterizing lesions, monitoring treatment response, and guiding biopsies.

Comparing Traditional Ultrasound and SWE

• Sensitivity and Specificity:
  • SWE demonstrates high sensitivity and specificity in differentiating benign and malignant breast lesions.
  • Combining traditional ultrasound with SWE enhances diagnostic accuracy.

Phoenix Ultrasound at Central London Branch

• Location:
  • Phoenix Ultrasound offers both traditional ultrasound scans and SWE at their Central London Branch:
    • Address: 1 Portpool Lane, Holborn, London, EC1N 7UU.
  • Booking Options:
    • Patients can book an appointment through Phoenix Ultrasound’s website or by calling

Conclusion

In summary, while traditional ultrasound remains valuable for anatomical assessment, shear wave elastography provides critical insights into tissue stiffness. Consider SWE for enhanced diagnostic precision and patient care. Regular breast health screenings are crucial, and consulting with healthcare professionals is essential for personalized guidance.

Remember that early detection and accurate imaging play a pivotal role in breast cancer management.