Influence of breast density on patient's compliance during ultrasound examination: Conventional handheld breast ultrasound compared to automated breast ultrasound

Abstract

Background: Our aim was to study the influence of breast density on patient's compliance during conventional handheld breast ultrasound (US) or automated breast US (ABUS), which could be used as adjunct screening modalities. Methods: Between January 2019 and June 2019, 221 patients (mean age: 53; age range: 24–89 years) underwent both US and ABUS. All participants had independently interpreted US and ABUS regarding patient compliance. The diagnostic experience with US or ABUS was described with a modified testing morbidity index (TMI). The scale ranged from 0 (worst possible experience) to 5 (acceptable experience). Standard statistics was used to compare the data of US and data of ABUS. Breast density was recorded with the Breast Imaging Reporting and Data System (BI-RADS) score. Results: The mean TMI score was 4.6 ± 0.5 for US and 4.3 ± 0.8 for ABUS. The overall difference between patients' experience on US and ABUS was statistically significant with P < 0.0001. The difference between patients' experience on US and ABUS in women with BI-RADS C and D for breast density was statistically significant with P < 0.02 in favor of US (4.7 ± 0.4) versus 4.5 ± 0.6 for ABUS. Patients' experience with breast density B was better for US (4.7 ± 0.4) versus 4.3 ± 0.6 for ABUS with P < 0.01. Pain or discomfort occurred during testing, especially in patients >40 years. Conclusion: Patient age (>40 years) is a significant predictor of decreased compliance to ABUS. Compliance of ABUS resulted lower that of US independently for breast density.

Evaluation of the patient experience and efficiency of breast cancer screening using automated breast ultrasound

“…Although patient discomfort has been noted in previous studies, ABUS has been identi ed as a good alternative to HHUS (10,16). The main cause of discomfort observed in this study was pain during the examination, which is similar to the results of a previous study (17). This increased pain is related to the methods of administration of ABUS.…”

“…In the present study, younger patients tended to be less satis ed with ABUS. In contrast, an ABUS compliance study by De Giorgis et al reported that older people (> 40 years) showed a decrease in compliance (17). Arguably, it is known that the breast density tends to be higher in young women, and patients with denser breasts feel more pain when the breast is compressed, whereas women with small breasts experience pain because of di culty under pressure (16).…”