Role of three-dimensional automated breast ultrasound as a breast screening tool in additional to mammography

Background
The biggest cause of cancer-related deaths among women globally is breast cancer. Breast cancer outcomes are improved by early identification; hence, survival rates are generally favorable when these tumors are found early. Radiologists play a crucial role in breast imaging. The ‘gold standard’ for screening and early detection of breast cancer at the moment is radiograph mammography. The majority of ‘intermediate risk’ women − those with a 15–25% lifetime risk of breast cancer − are women with thick breast tissue. The ‘perfect storm’ of reduced mammographic sensitivity and elevated breast cancer risk affects them.
Patients and methods
This is a prospective diagnostic study done from May 1, 2021 to May 30, 2022. Patients were recruited from those who had undergone screening using ultrasound examination [handheld ultrasound and automated breast ultrasound (ABUS)], and some of them had undergone mammography.
Results
In our investigation, 60 female patients had 60 findings that were validated by histopathological biopsy or at least 6 months of follow-up; 16 of the 60 findings were benign abnormalities and 44 were malignant lesions. The gold standard for lesion categorization, biopsy or 6-month follow-up, was used to determine the diagnostic accuracy of the ABUS test. In comparison to the reference index, the diagnostic accuracy metrics for ABUS were 90% accurate but with 88% sensitivity and 91% specificity. Positive predictive value was 78%, whereas negative predictive value was 95%. Positive likelihood ratio was 9.63, whereas negative likelihood ratio was 0.14, with relative risk being 16.33. False-positive rate was 9% and false-negative rate was 13%, with prevalence of 27%.
Conclusions
When used as a supplemental scan to mammography in a screening program for breast cancer, the automated breast ultrasound performs diagnostically similarly to handheld ultrasound. More imaging and interpretation training can increase the specificity of ABUS.