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Four out of five women who get a biopsy following a worrisome mammogram find that the mass poses no threat. That's a lot of unnecessary discomfort, which helps explain why there's been so much buzz about elastography, an experimental ultrasound technique that appears to have startling accuracy.
Elastography capitalizes on a peculiar aspect of cancerous breast tissue: It tends to be stiffer than benign masses. "Picture a marble in a bowl of Jell-O," says Richard G. Barr, MD, a professor of radiology at Northeastern Ohio Universities College of Medicine who has been testing the technology. "Then add slight compression." The compression comes from an ultrasound wand, which a technician rolls over the breast. The image is fed directly into a specialized software program that measures the elasticity of suspicious tissue.
In 2007, Barr reported the findings of a preliminary study at the annual meeting of the Radiological Society of North America. A group of women who were scheduled to get a biopsy first received elastography. Following the biopsy, Barr and colleagues compared the results. The ultrasound predicted 17 out of 17 malignancies and 105 out of 106 benign lumps—a rate verging on 100 percent accuracy.
Cheryl Perkins, MD, senior clinical adviser for Susan G. Komen for the Cure, agrees the news is exciting, though the results need to be verified in larger studies. "It's a small study, and we have a lot more that we need to learn about elastography," she says. Trials are under way at two European sites, and there are plans to add several U.S. sites.