Comparison of supplemental breast cancer screening outcomes for automated versus hand-held ultrasound

Authors

• Garth H. Rauscher, Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago; University of Illinois Cancer Center, Chicago.
• Nila Alsheik, Advocate Health - MidwestFollow
• Joanna Eavey, Kaiser Permanente Washington Health Research Institute, Seattle, WA.
• Laura Ichikawa, Kaiser Permanente Washington Health Research Institute, Seattle, WA.
• Hannah Perry, Department of Radiology, University of Vermont Medical Center, University of Vermont, Burlington, VT.
• Kathryn Lowry, Department of Radiology, University of Washington School of Medicine, Seattle, WA.
• Karla Kerlikowske, UCSF Department of Medicine, San Francisco, CA.
• Brian L. Sprague, Department of Surgery, University of Vermont Cancer Center, University of Vermont, Burlington, VT. Electronic address: [email protected].

Recommended Citation

Rauscher GH, Alsheik N, Eavey J, et al. Comparison of Supplemental Breast Cancer Screening Outcomes for Automated Versus Handheld Ultrasound. J Am Coll Radiol. 2026;23(10):1936-1945. doi:10.1016/j.jacr.2026.06.018

Abstract

Objective: Supplemental ultrasound as an adjuvant to screening mammography has expanded due in part to the implementation of state laws mandating breast density notification. Automated breast ultrasound (ABUS) is an emerging modality that can potentially improve reproducibility and reduce operator dependency associated with hand-held ultrasound (HHUS) in appropriately selected patients. The goals of these analyses were to compare the performance of ABUS versus HHUS for women with dense breasts.

Methods: We used observational data from 21,110 HHUS and 4,218 ABUS exams among women with dense breasts conducted during 2017-2020 at 27 radiology facilities within three Breast Cancer Surveillance Consortium (BCSC) registries. Differences in abnormal interpretation rate, short-interval follow-up recommendation rate, biopsy recommendation rate, and cancer detection rate, as well as the false-positive initial assessment rate, false-positive biopsy recommendation rate, and positive predictive values for initial assessment and biopsy recommendation were compared.

Results: ABUS was associated with a lower abnormal interpretation rate (14.9% vs. 19.2%, p

Conclusion: Compared to HHUS, ABUS was associated with fewer abnormal interpretations and fewer short-interval follow-up recommendations and with a similar cancer detection rate. ABUS should be considered by healthcare providers as an effective alternative to handheld ultrasound for screening of certain women with dense breasts.

Document Type

Article

PubMed ID

42398688