Evaluation of Directly Observed Short Course Treatment (DOTS) Program in Kerbala province in Iraq between 2005 and 2017

Objective: The aim of this study was to evaluate the clinical value of ultrasound elastography (USE) in differentiating benign from malignant breast masses. Methods: The study was conducted from January to August 2016 at Al Sader Medical City in Al Najaf, a total of 62 female patients. Each patient examined by B-mode US and those confirmed to have a breast mass were then assessed with strain elastography. A single ultrasound machine was used which was (VOLUSON E6, GE Austrian), and a linear probe was used to obtain the B-mode and elastography strain images. Results: Forty one breast masses on strain elastography had ≥ 2.72 SR, 37masses were proved to be malignant on histopathological examination and 4 were false positive proved to be benign masses. The study showed that the SR had Sensitivity=92.5%, Specificity =81.8%, PPV=90.2%, NPV=85.7%, with total Accuracy=88.7%. There was a significant difference (P<0.001) between the mean values of SR of malignant and benign masses, for the malignant masses it was 3.97 ± 1.47 while for benign masses it was 2.34 ± 0.88. According to the Tsukuba elasticity score, the elastogram score had Sensitivity=95%, Specificity=86.4%, PPV=92.7%, NPV=90.5% and the total accuracy = 91.9%. Conclusion: The present study allows for the conclusion that Sonoelastography presents a good diagnostic sensitivity (92.5%) and high diagnostic specificity (81.8%) in the differentiation between benign and malignant lesions, thus allowing for a reduction in the current number of breast biopsies.