A Symptomatologic Perspective to Sonoelastography: Correlation of Compressive Sonoelastography Findings with VAS Score for Breast Cysts

Objective: To investigate threshold values for the diameter, elasticity score and strain ratio for symptomatic breast cysts. Patients and Methods: Sonoelastography was performed prospectively to breast cysts determined by ultrasonography for consecutive patients evaluated in our breast ultrasonography unit. Just after the ultrasonography, the patients were asked to specify the severity of the pain, if any, associated with the lesion on the visual analogue scale (VAS). The longest and shortest diameters of the cyst, short/long diameter ratio, strain ratio and elasticity score obtained by ultrasonography and sonoelastography were compared with VAS scores. For symptomatic cysts (VAS≥1) to obtain the threshold values, the long and short diameter, short/long diameter ratio, elasticity score and strain ratio were analysed by receiver-operating characteristic (ROC) tests. Results: The area under the curve (AUC) values obtained by ROC analysis were 0.835, 0.857, 0.729, 0.780 and 0.680 for long and short diameters, short/long diameter ratio, elasticity score and strain ratio, respectively. The short diameter is considered the most valuable parameter according to the AUC values. A threshold of 8.5-mm for short diameter had a sensitivity of 80% and specificity of 86% for symptomatic cysts. A threshold value of 2 for elasticity score had a sensitivity of 70% and a specificity of 86%, while a threshold of 1.2 for the strain ratio had a sensitivity of 51% and a specificity of 72%. Conclusion: This study concluded that expanded and relatively hard cysts (are likely to be symptomatic