The performance of 3D ABUS versus HHUS in the visualisation and BI-RADS characterisation of breast lesions in a large cohort of 1,886 women
This study aimed to evaluate automated breast ultrasound (ABUS) compared to hand-held traditional ultrasound (HHUS) in the visualisation and BIRADS characterisation of breast lesions.
Materials and methods
From January 2016 to January 2017, 1,886 women with breast density category C or D (aged 48.6±10.8 years) were recruited. All participants underwent ABUS and HHUS examination; a subcohort of 1,665 women also underwent a mammography.
The overall agreement between HHUS and ABUS was 99.8 %; kappa=0.994, p<0.0001. Two cases were graded as BI-RADS 1 in HHUS, but were graded as BIRADS 4 in ABUS; biopsy revealed a radial scar. Three carcinomas were graded as BI-RADS 2 in mammography but BI-RADS 4 in ABUS; two additional carcinomas were graded as BI-RADS 2 in mammography but BI-RADS 5 in ABUS. Two carcinomas, appearing as a well-circumscribed mass or developing asymmetry in mammography, were graded as BI-RADS 4 in mammography but BI-RADS 5 in ABUS.
ABUS could be successfully used in the visualisation and characterisation of breast lesions. ABUS seemed to outperform HHUS in the detection of architectural distortion on the coronal plane and can supplement mammography in the detection of non-calcified carcinomas in women with dense breasts.
• The new generation of ABUS yields comparable results to HHUS.
• ABUS seems superior to HHUS in detecting architectural distortions.
• In dense breasts, supplemental ABUS to mammography detects additional cancers.
KeywordsAutomated breast ultrasound system Breast ultrasonography Breast cancer Breast density Digital mammography
- 3D ABUS
Three-dimensional automated breast ultrasound system
Atypical ductal hyperplasia
Atypical lobular hyperplasia
Breast Imaging Reporting and Data System
Ductal carcinoma in situ
Field of view
Invasive ductal carcinoma
Invasive lobular carcinoma
Lobular carcinoma in situ
The authors would like to thank the technologists Kalliopi Konstantinakou and Evangelia Stamatiou for their contribution in performing ABUS, mammography and collecting the data.
Compliance with ethical standards
The scientific guarantor of this publication is Athina Vourtsis MD, PhD, Founding President of the Hellenic Breast Imaging Society.
Conflict of interest
The authors of this manuscript declare relationships with the following companies: The corresponding author has received honoraria from GE Healthcare for giving lectures and for moderating workshops.
The authors state that this work has not received any funding.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Written informed consent was obtained from all subjects (patients) in this study.
Institutional Review Board approval was obtained.
• performed at one institution
- 11.Wilczek B, Wilczek HE, Rasouliyan L, Leifland K (2016) Adding 3D automated breast ultrasound to mammography screening in women with heterogeneously and extremely dense breasts: Report from a hospital-based, high-volume, single-center breast cancer screening program. Eur J Radiol 85:1554–1563CrossRefPubMedGoogle Scholar
- 14.American College of Radiology (2013) BI-RADS: ultrasound. Breast imaging reporting and data system atlas. 5th ed. American College of Radiology, RestonGoogle Scholar
- 18.Gotzsche PC, Nielsen M (2006) Screening for breast cancer with mammography. Cochrane Database Syst Rev 4:CD001877Google Scholar