Automated breast ultrasound in breast cancer screening of mammographically dense breasts: added values

Full-field digital mammography (FFDM) is the primary screening method for breast cancer, yet the number of cancers that can be missed with mammography is considerable, notably in female with dense breast. In this study, we compared the diagnostic yield and the clinical significance of FFDM for breast cancer detection in female with dense breasts versus its performance when complemented by automated breast ultrasound (ABUS). This retrospective study was performed during the period between January 2022 and December 2022 including 500 females with dense breast (ACR C&D), who underwent screening using FFDM and ABUS. The images were retrospectively interpreted, and statistical assessments were done comparing the FFDM results alone and after complemented with ABUS. Significance was considered at a p value less than 0.05. The use of FFDM with supplemental ABUS has reduced the numbers of recall and showed improved breast cancer detection with increased positive predictive value (from 74.5 to 83.5%). In comparison, using FFDM alone and associated with ABUS, there was moderate agreement with a kappa test of 0.51; p < 0.001. ABUS can be a useful and powerful diagnostic imaging tool when adjunct to FFDM for screening of dense breast. In this study, ABUS showed less false-negative results and improved the sensitivity of cancer detection.