 Hello everyone. My name is Dr. Rasika Chaudhary, junior resident from the department of lead diagnosis, GMC NACP. The topic for my paper presentation is the role of ultrasound in conjunction with industrial therapy in differentiating breast muscle type NACC correlation. Now moving on to the introduction, breast cancer is a commonest cancer in women worldwide with a widely variable incidence between regions. The peak in students in developed countries is about the age of 40, 50 years whereas in India it is slightly earlier that is about the age of 40 years. The detection of breast cancer is the earliest possible stage therefore it is the ultimate goal of imaging the breast and the role of radiology is therefore vital. The various modalities are available like mammography, sonography, elastography, MR without contrast, MR elastography and tone mammography. The different advantages of ultrasound over other modalities are it helps to differentiate between cystic and solid masses. The pancreas muscle is not visible in radiography with dense breast for abscess or potassium ultrafone. Masses that are not completely evaluated with mammography or cancer is obscured mammographically by dense breast tissue is seen better on ultrasound and in young patients who are susceptible to radiation damage they can have advantage of ultrasound over mammography. Therefore the American cause of radiologist states that USC should be used as a post-life investigation tool for part of the masses in women. The answer of that is of my study with the differentiate between the breast masses and to be an intelligent ultrasound in conjunction with elastography to correlate the imaging findings with FNSE or biopsy and to study the role of bioreal staging in preoperative tumor staging of breast malignancies. Methods. Patient's trip to the department of radiology, GMC NACPOS for ultrasound of breast were matched with the inclusion criteria and those in the inclusion criteria were excluded. A short relevant clinical institute was taken along with the family history if any and also the previous ultrasound findings were compared with the current findings if available. The sample is set up to be 30. The study was a prospective observational study with time frame was May 2020, September 2020. All patients leopard for breast ultrasound is with symptoms like palpable lung, breast injury or nipple discharge, breast discomfort or retraction of nipple and who further underwent FNSE or biopsy were included and institution criteria were patient's usage in the department who had already been assessed for their breast masses or already had history of pyridine breast with a new mass vision were excluded. The conventional positioning was given for breast ultrasound with the supine position and uplifted behind the head. The bilateral breast and axilla were evaluated on B scale and on color Doppler modes. The patients were examined in overlapping scans in radial and anti radial planes from nipple to periphery into orthogonal planes. If a lesion was found, the history in the astrographic was also performed. The original was described on the following headings like shape, margins, ecogenicity, calcification through internal muscularity and associated findings the presence of lymph nodes, fatty, halum, presence in measure of the pectoralis muscle surrounding structures and vector involvement. Subsequently, the USG biotech category was assigned to the masses. The history in the astrographic was performed by obtaining an elastogram which was made up of firing sheets of blue to red, blue towards software or benign category and red is towards more hard or stiff category towards malignant category. The dual split screen was used with one side with the conventional beam mode and the other side described the elastographic image. The patients were followed up and the HV outcome of the patient was noted down. This was the elastrary scoring system used which was the supra scoring system which had a scoring of 1, 2, 3, 4 and 5. 1, 2, 3, benign and 4 and 5 towards malignant. Now the results or observation results of the study, the age distribution of the study. The age group ranges from 21 to 78 years. The maximum number of patients seen were more than 60 years of age group. Next highest number were in the age of 41 to 50 years which compares 26 percent to study population. There is a list where less than 30 years of age. Now study compares of zero males forming 0 percent of the population and all the patients with females. Families due to a passion of breast out of 30 cases only 6 patients forming 20 percent of study population had a family of breast cancer that is 24 percent had a new history of breast cancer. These were the USG findings with various characteristics. Most of the lesions were hypoechoic 60 percent of the study group and 10 lesions had mixed equal genocity whereas 2 lesions were n equal. 11 lesions had double edged margins, 18 lesions had irregular margins, only 2 lesions had smooth margins. Calcification was seen in 20 cases at 66 percent whereas absent in 10 lesions. Interescalarity was demonstrated in 25 out of the 30 lesions and 83.3 percent that is. Vascalarity was present whereas no escalarity could be demonstrated in breast. Lesions showing morphology wider than taller was seen in 12 that is 40 percent of the study group where a 60 percent of the study morphology showed taller than wider which is like this is just a malignancy. This is the illustration graphic score wise distribution which showed that out of the 30 lesions maximum number of lesions had illustrographic score of 4 comprising 46.6 percent of the study population. The second most common score given was one seen in 11 lesions forming 36 percent of the population. Now this was the character of the lesion according to the illustration graph findings based on the illustration graphics score. 13 out of the 30 lesions had benign score 17 had a malignant score which was suggested of malignancy based on the illustration graphic findings. This was the bias wise for distribution of lesion. Magazine number of lesions were categorized as 4 corresponding to probably malignant lesion with likelihood of cancer to 95 percent which comprised 66 percent of the population. The next most common was Barrett's 5 which is a high likelihood of cancer more than 95. This category compressed 26 percent of the population. This was the distribution of lesion according to the histopathology. 14 cases had benign Hp compressed 46 percent of the study population and 16 cases were approved to the malignant which compressed 53.3 percent of the population. So, this was the correlation between illustration graph and Hp findings. The test we used was Gasko artist statistically significant correlation was found between the illustration graph and the Hp outcome with the p value of 0.03 which was less than 0.05. The positive value to value was 76.9 percent and negative value to value was 76.4 percent. Then the correlation between the combined condition USG and illustration graph Hp was again high that is the p value came out to be 0.02. The combined priority value was 77.78 combined negative priority value was 66.6 and accuracy of the two examinations combined was 70 percent. This is the correlation between USG plus illustration graph and rest of the finding in the study within the schematic way which shows the significant statistical significance of the combined USG plus illustration graph and Hp findings. So, the confusion of the study was we consider in this prospective study that combined illustration graph with the conventional ultrasound which has more specificity and positive value as compared to illustration graph alone and illustration graph is a significant additive for determining need for biopsy of the masses. Now, moving on to some images. This was a 24 year old female who came with a complete of painless lump in left breast with no history of nipple discharge or retraction. Now, this was the B1 ultrasound which shows a well defined round to oval lesion seen in the upper outer quadrant of left breast which had a regular margin set places which appears wider than total with no calcified cockey within no evidence of significant architectural distortion or which is a doctor involvement scene. This was given as a bayonets too. Then on elastography we can see there are areas of blue and green areas of mosaic that is most of the lesion is deformable although there are areas which are not deformable. So, this was given as a score too. On further follow-up, this came out to be a fibroidinoma with epithelial hyperplasia. Therefore, consistent with the findings. Now, case two of 56 year old female who came with a complete of fetum increase in the size of this woman with no history of pain nipple discharge or retraction but we more ultrasound we can see a well defined, low belated round to oval lesion seen in the lower outer quadrant of left breast which has a few calcifications within which has regular margins which appears wider than total and no evidence of cystic areas who adjacent involvement can be seen in this image like that of involvement etc. Then on the elastogram we can see the lesion appears the elastogram appears homogeneously blue with few green areas within the lesion and the adjacent tissues are blue that is no deformation is seen throughout the entire lesion or in the adjacent tissue. Therefore, this was even a scuba score of five. On color Doppler, it was taking some vascularity therefore the score was increased from bayonets to bayonets 4c. Then on further follow-up of FNAC we found out that it was getting moderately proliferative stroma neoplasm with OTPF. Therefore, the findings were significantly consistent. Now, case three, 37 year old female who came with painless palpable lump in right breast with no history of nipple infection or discharge on B-moral ultrasound, we can see a relatively well defined hypoechoic lesion seen in adjunction of the at 12 o'clock position in the right breast with lobelated and irregular margin set places with no calcifications within which appears taller than wider with most of the addition features in this image which was given as a bayonets 3. Then on the elastogram we can see that the lesion it is it shows mixed areas of blue and green which and adjacent red green areas which shows that the deformality in the periphery of the lesion although the center is blue. Okay, so this is a given as scuba score 3 and color Doppler it was taken was taking mild peripheral vascularity. On follow this came out to be a fibroidinoma or phyloids tumor. Now, case four, 40 year old female with lump in left breast and nipple detection present nose to a pain. On B-moral ultrasound, we can see a regular indefined hypoechoic lesion seen in the retrovalua region of left breast with irregular margins which appears here it appears wider than taller then it was given a score of bayonets 5 and on elastogram it was a the tissue appears homogeneously blue that is the lesion and this is a blue and no deformation throughout the entire region is seen. Therefore, this was given as a scuba 5 which has a high risk of malignancy. On follow this came out to be a ductile carcinoma. The last case of 40 year female with painless lump in left breast nose to a nipple discharge or retraction was well defined round oval or a hypoechoic cystic lesion seen it was stochastic enhancement in the at 3 o'clock position in at 9 o'clock position in left breast and no adjacent features it appears wider than taller and on elastography it was showing a blue-green-red layering which is a typical of cystic lesions. On FNC it came out to be a simple breast. So, these are my references. Thank you.