 Hello everyone. My topic of presentation is Sonomaemographic and Sonoelastrographic evaluation of benign and malignant breast lesions and its correlation with fine needle aspiration cytology. My name is Dr. Anisha Mondal, 2nd year junior resident, Department of Redo-Ragnosis-Vacrosome Melodimerical College and my co-author is Dr. Khushabh Gaur, senior resident of the same department and same college. Introduction. Breast cancer affects 25.8% of women worldwide. Ultrasonic gastrography is a non-invasive imaging method that can measure the tissue stiffness related to different pathologic conditions based on the idea that malignant tumors are stiffer under compression. Pre-size undisturbedification and ping-pointing in the e-mode is a promising alternative to the confessional ultrasonic gastrography. Aim of the study to assess the diagnostic accuracy of sonomaemography and sonoelastrography in diagnosing breast lesions in correlation with FNHC as cold standard. To classify lesions according to bidiars and sonoelastrography. To correlate the above findings with FNHC. To calculate the diagnostic accuracy and thus reducing the need for FNHC. To compare the diagnostic accuracy in case of suspicious sonomorphic features. Materials and methods. Study type analytical, study design cross-sectional. Paste of the study is sonology room in our college. Sample size is 52 female patients with breast lesions. Study tools are G-altersonoprophymation with 3 to 12 megahertz linear strength distance and FNHC reports from the department of pathology. Inclusion criteria. All the female patients aged 18 years and above refer to the radio diagnosis department for ESC of the breast lesion. Exclusion criteria. Patients not capable of giving consent. Not willing to participate in the study. Unfit for FNHC or postdoc bilateral mastectomy patient. Already diagnosed patient and the lesion which are indeterminate by FNHC. These are the bidiars category which are very known to us. Now strange illustration of the breast lesion. At first the patient is placed in supine position. Then the probe oriented perpendicular to the chest wall. Then moderate vertical collide compressions is applied over the lamp. 3 to 5 times. Then they bring more briskly image and the illustrative image are dispersed side by side. This is the illustrative score or the sukuba score. Above score 4 is considered as malignant and below that is benign. Score 1 consists of lesion which are completely deformable and the increasing the score, score 5 is the lesion which are stiff and the surrounding area are also stiff. Size ratio. Malignant ratio are known to appear larger in size in elastogram than on the b-mode images. It is calculated dividing the illustrative image size by the b-mode size. Cutoff point or motor equal to 1.2 is considered as malignant in this study. Strain ratio also known as fast acceleration ratio when applied to breast. It measure how stiff the lesion in comparison to the tissue around it. Strain ratio is measured by mean strain ratio of fat area divided by mean strain in the lesion of interest. Malignancy is predicted by strain ratio of motor equal to 4.5 in this study. This is a case of fibrotonoma on strain historiography with sukuba score 2, strain ratio of 1.9 and size ratio of 0.99. This is a case of DCI with b-score 4 and sukuba score 5, strain ratio of 1.9. Result. This shows the pathological distribution of the breast lesion in which we can see the fibrotonoma is the most common that is 44% and among the malignant lesion Dr. Karsinoma in C2 is more common that is 15%. This is the age distribution of benign and malignant breast lesions in which we can see in the younger age group the benign lesions are more common in the older age group the malignant lesions are more common. This table is the correlation of sonomemograph and sonorehastrography with the FNAC accuracy. Modalities are at wide-race restrography score, strain ratio and size ratio. All of the modalities have p-value of less than 0.0001. Discussion. This table number 2 shows illustrative score wise distribution of the cases in which mean illustrative score for benign and malignant lesions are 2.1 and 4.69 respectively. These values are similar to a study conducted by Akavito and Kulix in 2004. Table 3 shows the strain ratio wise distribution of the cases in which mean strain ratio for benign and malignant lesions are 2.58 and 8.54. In table 4 there is the size ratio wise distribution of the cases in which the mean size ratio for benign and malignant lesions are 0.97 and 1.35 respectively. These values in the two tables are in concordance with the study by seeing it all in 2020. Accuracy of birars in diagnosing benign versus malignant lesions was 86.5% which is lower as compared to illustrative score with accuracy of 90.3%. The sensitivity of strain ratio was 85.7% which was similar to sensitivity of size ratio and that of birars indicating no significant difference between these days. These findings were in concordance with a study by Kyao Ling-Zao in 2012 which showed sensitivity of strain ratio to be 87.7% when a cut-off value of more or equal to 3.06 was considered. Conclusion, this study shows that based illustration with conventional ESG can reach the high specificity and high negative predictive value. It is here to classify birars three category lesions which are benign with a probability of malignancy and thus leading to further patient suffering, cost and resource wastage. Birars category 3 and 4 lesions with benign findings on sonorastography can be downgraded to category 2 and 3 respectively thus reducing the number of false positive malignancy cases and further follow-up and biopsy. These are the references used in this study. Thank you.