Korean J Radiol.  2020 Jan;21(1):15-24. 10.3348/kjr.2019.0176.

Automated Breast Ultrasound Screening for Dense Breasts

• Kim SH
• Kim HH
• Moon WK

• KMID: 2467038
• DOI: http://doi.org/10.3348/kjr.2019.0176

Abstract

Mammography is the primary screening method for breast cancers. However, the sensitivity of mammographic screening is lower for dense breasts, which are an independent risk factor for breast cancers. Automated breast ultrasound (ABUS) is used as an adjunct to mammography for screening breast cancers in asymptomatic women with dense breasts. It is an effective screening modality with diagnostic accuracy comparable to that of handheld ultrasound (HHUS). Radiologists should be familiar with the unique display mode, imaging features, and artifacts in ABUS, which differ from those in HHUS. The purpose of this study was to provide a comprehensive review of the clinical significance of dense breasts and ABUS screening, describe the unique features of ABUS, and introduce the method of use and interpretation of ABUS.

Keyword

Dense breast; Automated breast ultrasound; Screening; Early detection of cancer; Breast cancer

MeSH Terms

Artifacts
Breast Neoplasms
Breast*
Early Detection of Cancer
Female
Humans
Mammography
Mass Screening*
Methods
Risk Factors
Ultrasonography*

Figure

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  Fig. 1 Flow chart provided by Japanese Association of Breast and Thyroid Sonology for assessing mass lesions.

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  Fig. 2 ABUS with dedicated scanner and workstation. A. ACUSON S2000 Automated Breast Volume Scanner (Siemens Healthineers) comprises of scanner and special stationary device with transducer. B. Images are obtained in three to five views per breast. C. Workstation provides three-dimensional reconstruction view, and display mode is chosen from four settings. ABUS = automated breast ultrasound, AP = anteroposterior

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  Fig. 3 ABUS image of 58-year-old woman with right breast cancer. Axial (upper column), coronal (right lower column), and sagittal (left lower column) images show irregular spiculated hypoechoic mass measuring 2.2 cm. Retraction phenomenon is seen in coronal view.

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  Fig. 4 ABUS image of 44-year-old woman. Axial and coronal images show few cysts. White-wall sign is seen in coronal view (arrowheads).

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  Fig. 5 ABUS image of 49-year-old woman with atypical papilloma. Three orthogonal views reveal segmental non-mass lesion of intraductal masses measuring 4.8 cm (arrowheads).

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  Fig. 6 ABUS image of 46-year-old woman. Axial and sagittal images demonstrate nipple shadow, and reverberation artifact is seen as hypoechoic area with shadowing and multiple parallel echogenic lines (circles). This was interpreted as space occupying lesion, but handheld ultrasound showed no focal lesions (not shown). Therefore, this is false-positive case.

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  Fig. 7 ABUS image of 28-year-old woman with fibroadenoma. Three orthogonal views show circumscribed oval hypoechoic mass measuring 8.2 cm. Coronal and sagittal images demonstrate skip artifact as transverse line (arrowheads) above mass.

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  Fig. 8 ABUS image of 53-year-old woman with left breast cancer. Computer-aided detection with QVCAD (Qview Medical Inc.) system shows cancer and marks suspicious mass with green circles.

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