Comparison of Automated Breast Volume Scanning and Hand-Held Ultrasound in the Detection of Breast Cancer: an Analysis of 5,566 Patient Evaluations

Abstract

Background: The purpose of this study was to compare the accuracy and effectiveness of automated breast volume scanning (ABVS) and hand-held ultrasound (HHUS) in the detection of breast cancer in a large population group with a long-term follow-up, and to investigate whether different ultrasound systems may influence the estimation of cancer detection. Materials and Methods: Institutional review board approval was obtained for this retrospective study, and informed consent was waived. From September 2010 to August 2011, a total of 1,866 ABVS and 3,700 HHUS participants, who underwent these procedures at our institute, were included in this study. Cancers occurring during the study and subsequent follow-up were evaluated. The reference standard was a combination of histology and follow-up imaging (≥12 months). The recall rate, cancer detection yield, diagnostic accuracy, sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values were calculated with exact 95% confidence intervals. Results: The recall rate was 2.57 per 1,000 (48/1,866) for ABVS and 3.57 per 1,000 (132/3,700) for HHUS, with а significant difference (p=0.048). The cancer detection yield was 3.8 per 1,000 for ABVS and 2.7 per 1,000 for HHUS. The diagnostic accuracy was 97.7% for ABVS and 96.5% for HHUS with statistical significance (p=0.018). The specificity of ABVS and HHUS were 97.8%, 96.7%, respectively (p=0.022). Conclusions: ABVS shows a comparable diagnostic performance to HHUS. ABVS is an effective supplemental tool for mammography in breast cancer detection in a large population.

Diagnostic Performance of Automated Breast Ultrasound in Differentiating Benign and Malignant Breast Masses in Asymptomatic Women: A Comparison Study With Handheld Ultrasound

“…A combination of pathologic examinations and follow‐up imaging (≥12 months) was used as a reference standard in that report. There were different results in the reports by Chen et al and Choi et al compared with our study. Two main factors may have contributed to the difference.…”

“…At the beginning of the study, many factors that might have led to a bias in the results were excluded, such as patients with visible, suspicious signs of breast cancer and those who had received a diagnosis or treatment of breast cancer. Second, different reference standards were used, A combination of pathologic results with follow‐up imaging (≥12 months) was included in our study, which was similar to the report by Choi et al but different from the report by Chen et al On the one hand, compared with some other studies based on pathologic results, the lack of consensus was a limitation. On the other hand, we used pathologic results and 1‐year follow‐up data as reference standards.…”

“…Pathologic results were used as the reference standards in that report. However, in a report by Choi et al with a large sample (1866 ABVS and 3700 HHUS participants among 5566 women), a significant difference was observed between ABVS and HHUS in terms of specificity (86.2% versus. 87.5%; P = .018) and diagnostic accuracy (97.70% versus 96.54%; P = .022), but there was no difference in terms of sensitivity (77.78% versus 62.50%; P > .05).…”

“…These advantages could enable ABUS to become a very useful modality for the diagnosis of breast cancer . Several similar diagnostic studies have been performed to compare ABUS and HHUS, but most of the studies have produced different results . As most of the reports were retrospective studies, some confounding factors that might have affected the results could not be excluded.…”

Automated Breast Ultrasound: Dual-Sided Compared with Single-Sided Imaging

“…Several recent studies have demonstrated that the diagnostic power of automated breast ultrasound (ABUS) is comparable to that of handheld imaging. One such study reported a diagnostic accuracy of 97.7% for ABUS and 96.5% for hand scanning Choi, et al 2014). In another study, analysis of ABUS images and images from hand-scanning led a perfect match-up in the masses classified at BI-RADS categories 4 and 5.…”