Breast Ultrasound: Advanced Techniques

Several additional techniques are now widely available when performing handheld breast US which may be helpful in routine clinical practice and others which show research potential. These include various forms of elastography including strain and shear wave techniques and Doppler assessment of vascularity with and without contrast. The most useful technique is shear wave elastography (SWE) which allows quantitative and reproducible analysis of tissue stiffness. Cancers tend to be stiff and benign lesions soft. SWE can be used successfully to differentiate benign from malignant lesions, monitor neoadjuvant chemotherapy, and predict nodal metastasis and outcome. Superb vascular imaging is the most promising vascular modality and it may be useful in monitoring neoadjuvant chemotherapy and benign/malignant differentiation.