Automated breast ultrasound provides comparable diagnostic performance in opportunistic screening and diagnostic assessment

To assess the performance of automatic breast ultrasound (ABUS) as an adjunct to digital breast tomosynthesis (DBT) in screening and diagnostic setting. Cross sectional study of women who underwent DBT and ABUS from December 2019 to March 2022. Inclusion criteria include opportunistic and targeted screening cases as well as symptomatic women. The breast density, BI-RADS categories and histopathology reports were collected and compared. The PPV3 (the proportion of examinations with abnormal findings that result in a tissue diagnosis of cancer), biopsy rate (percentage of biopsy performed) and the cancer detection yield (the number of malignancies found by the diagnostic test to the study sample) were calculated. A total of 1089 ABUS examinations were performed (age range: 29 - 85 years (mean: 51.9)). There were 83.5%(n=909) screening and 16.5% (n=180) diagnostic examinations. A total of 579 biopsies were performed on 407 patients, with a biopsy rate of 53.2%. There were 9.2%(n=100) malignant, 5.2%(n=30) atypical/B3 lesions and 71.5% (n=414) benign cases. There were 0.08%(n=9) cases where ABUS detected malignancies alone. There were 1.7%(n=19) cases where malignancies were detected in DBT alone. PPV3 in the screening group was 14.6%. ABUS is useful as an adjunct to DBT in the opportunistic screening and diagnostic setting.