ABUS vs. HHUS Supplemental Breast Cancer Screening Outcomes
A new Breast Cancer Surveillance Consortium (BCSC) study finds automated ultrasound outperformed handheld scanners as a supplemental screening method for women with dense breasts.
There is increasing demand for supplemental ultrasound screening following the enactment of state laws and federal rules requiring radiology clinics to inform women with dense breasts about the limitations of mammography. Handheld ultrasound (HHUS) has long been available for breast imaging, but it has drawbacks related to limited reproducibility. There is an increasing interest in using automated breast ultrasound (ABUS) in place of HHUS for supplemental breast cancer screening. ABUS could potentially overcome the drawbacks associated with HHUS and also provide a means to expand supplemental ultrasound screening capacity at radiology clinics. A new study from the Breast Cancer Surveillance Consortium (BCSC), published in the Journal of the American College of Radiology, compared breast cancer diagnostic outcomes between HHUS and ABUS. In this large observational study, we collected clinical data from 27 radiology facilities in the United States and analyzed the screening performance of ABUS and HHUS as performed in clinical practice. We collected detailed data on patient characteristics to statistically control for potential confounding by demographic and risk factors. We found that ABUS and HHUS had similar cancer detection rates, while ABUS resulted in fewer women being called back for diagnostic workup: ABUS was associated with a lower abnormal interpretation rate (14.9% versus 19.2%, P < .0001) and a lower false-positive initial assessment rate (14.6 versus 19.1; P < .0001) compared with HHUS. While prior studies have evaluated ABUS and HHUS separately, we are not aware of any that directly compare ABUS and HHUS screening performance in clinical practice in the United States. The results of our study provide the strongest evidence to date supporting the use of ABUS as an alternative to HHUS for supplemental screening of women with dense breasts.
Garth H. Rauscher, Nila Alsheik, Joanna Eavey, Laura Ichikawa, Hannah Perry, Kathryn Lowry, Karla Kerlikowske, Brian L. Sprague. Comparison of Supplemental Breast Cancer Screening Outcomes for Automated Versus Handheld Ultrasound. Journal of the American College of Radiology, Published online, July 3, 2026. doi:10.1016/j.jacr.2026.06.018. [link]
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