Screening Breast Ultrasound Using Handheld or Automated Technique in Women with Dense Breasts

Wendie A Berg; Athina Vourtsis

doi:10.1093/jbi/wbz055

Screening Breast Ultrasound Using Handheld or Automated Technique in Women with Dense Breasts

J Breast Imaging. 2019 Dec 5;1(4):283-296. doi: 10.1093/jbi/wbz055.

Authors

Wendie A Berg¹, Athina Vourtsis²

Affiliations

¹ University of Pittsburgh School of Medicine, Magee-Womens Hospital of the University of Pittsburgh School of Medicine, Department of Radiology, Pittsburgh, PA.
² Diagnostic Mammography Medical Diagnostic Imaging Unit, Athens, Greece.

PMID: 38424808
DOI: 10.1093/jbi/wbz055

Abstract

In women with dense breasts (heterogeneously or extremely dense), adding screening ultrasound to mammography increases detection of node-negative invasive breast cancer. Similar incremental cancer detection rates averaging 2.1-2.7 per 1000 have been observed for physician- and technologist-performed handheld ultrasound (HHUS) and automated ultrasound (AUS). Adding screening ultrasound (US) for women with dense breasts significantly reduces interval cancer rates. Training is critical before interpreting examinations for both modalities, and a learning curve to achieve optimal performance has been observed. On average, about 3% of women will be recommended for biopsy on the prevalence round because of screening US, with a wide range of 2%-30% malignancy rates for suspicious findings seen only on US. Breast Imaging Reporting and Data System 3 lesions identified only on screening HHUS can be safely followed at 1 year rather than 6 months. Computer-aided detection and diagnosis software can augment performance of AUS and HHUS; ongoing research on machine learning and deep learning algorithms will likely improve outcomes and workflow with screening US.

Keywords: automated breast ultrasound; breast cancer; breast density; cancer screening; computer-aided diagnosis; dense breasts; screening ultrasound.