**4.1 The coupling of conventional echography**

The coupling of conventional echography (which underestimates the size of the lesions) with Strain or SWE elastography has resulted in a significant improvement in the measurement of the size and extent of the lesions (calculation of the longest axis, the perimeter and the extent). The histological sections and the SWE measurements were identical (give or take 2 mm) according to some authors. In its calculations, elastography integrates changes in extra cellular matrix, inflammation and stroma remodelling (myofibroblasts and collagen) in invasive cancers (**Figure 12**).
