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All breast lesions were confirmed by surgery or biopsy. The significance of differences in ultrasound elastography values between breast benign and malignant masses with posterior acoustic shadowing was assessed, and the ROC curves of elasticity modulus values were analyzed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Among the 117 masses, 72 were benign and 45 were malignant. The two types of breast masses showed significant differences in size, margin, internal echo, calcification, and blood flow characteristics (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05), although the difference in orientation was not significant (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). <jats:italic>Emean<\/jats:italic>, <jats:italic>Emax<\/jats:italic> and <jats:italic>Esd<\/jats:italic> obtained with real time shear wave elastography showed statistically significant differences between benign masses with posterior acoustic shadowing and breast cancer (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05), while <jats:italic>Emin<\/jats:italic> showed no significant difference between them (<jats:italic>P<\/jats:italic>\u2009=\u20090.633). Ultrasound real time shear wave elastography showed higher sensitivity and specificity than conventional ultrasound.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Benign and malignant breast masses with PAS show different ultrasound manifestations. Real time shear wave elastography can facilitate the differential diagnosis and treatment planning for these breast masses.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12880-022-00797-3","type":"journal-article","created":{"date-parts":[[2022,4,17]],"date-time":"2022-04-17T08:02:46Z","timestamp":1650182566000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Stiffness in breast masses with posterior acoustic shadowing: significance of ultrasound real time shear wave elastography"],"prefix":"10.1186","volume":"22","author":[{"given":"Hui","family":"Luo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Shi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaojun","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuanyang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhanghong","family":"Wei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinfeng","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,4,17]]},"reference":[{"key":"797_CR1","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1007\/s40846-015-0031-x","volume":"35","author":"Z Zhou","year":"2015","unstructured":"Zhou Z, Wu S, Chang KJ, et al. 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Written informed consent was obtained from all participants during enrollment.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The corresponding author Jinfeng Xu has received a research grant from National Natural Science Foundation of China. The first author Hui Luo has received grant from Sanming Cultivation Project of Medicine in Shenzhen. All the co-authors declare that they have no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"71"}}