A pilot study to evaluate assisted freehand ultrasound elasticity imaging in the sizing of early breast cancer: a comparison of B-mode and assisted freehand ultrasound elasticity ultrasound with histopathology measurements

Purpose

Preoperative breast cancer sizing is required for surgical planning. Breast ultrasound is widely used but may not be accurate. Assisted freehand ultrasound (AFUSON) of the breast is a novel method of ultrasound scanning, combining semi-automated elasticity ultrasound with B-mode imaging. This pilot study investigates whether AFUSON sizing corresponds more closely with wide local excision tumour dimensions than with B-mode alone.

Methods

Twenty-three patients with early breast cancer were recruited with ethical approval through the NHSBSP. B-mode ultrasound and AFUSON images were acquired in predefined planes. Pathology slices were taken in the corresponding longitudinal plane and were digitally scanned. Assessment of tumour dimensions, area and contour were made on B-mode, AFUSON and histopathology scans. The findings were correlated.

Results

Although there were significant limitations in this pilot study, the tumour dimension accuracy increased from 66% (B-mode alone) to 82% (AFUSON). Tumour area accuracy increased from 61% (B-mode alone) to 90% (AFUSON). Some AFUSON contour images showed a high visual correlation with the equivalent histopathology scans.

Conclusions

This pilot study suggests that AFUSON may be useful in early breast cancer sizing. Further studies will be done to acquire more data and to address some of the shortfalls in the study.