Breast ultrasonography (US) is currently considered the first-line examination in the detection and characterization of breast lesions. However, conventional handheld US (HHUS) has several limitations such as operator dependence and the requirement of a considerable amount of radiologist time for whole-breast US. Automated breast US (ABUS), recently approved by the United States Food and Drug Administration for screening purposes, has several advantages over HHUS, such as higher reproducibility, less operator dependence, and less required physician time for image acquisition. In addition, ABUS provides both a coronal view and a relatively large field of view. Recent studies have reported that ABUS is promising in US screening for women with dense breasts and can potentially replace handheld second-look US in a preoperative setting.

Comparison of Automated Breast Volume Scanning and Hand-Held Ultrasound in the Detection of Breast Cancer: an Analysis of 5,566 Patient Evaluations Breast cancer;automated breast volume scanning;ultrasound;screening; 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 (${\geq}12months$). 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 a 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.

OBJECTIVE. The purpose of this study is to investigate whether clinicopathologic factors and dynamic contrast-enhanced MRI (DCE-MRI) features are associated with pathologic tumor response to neoadjuvant chemotherapy (NAC) in patients with triple-negative breast cancer (TNBC). MATERIALS AND METHODS. Seventy-three patients with TNBC who underwent pre-NAC MRI, completed NAC, and underwent surgery between January 2009 and December 2010 were included in the study. MRI features and clinicopathologic factors for predicting pathologic responses were analyzed, and residual tumor sizes, as measured using MRI and surgical specimens, were evaluated. RESULTS. Of 73 study patients, 20 (27%) had a pathologic complete response (pCR). Homogeneous enhancement on pre-NAC MRI (odds ratio from multivariate analysis, 14.66) and a concentric shrinkage pattern of tumor volume reduction on post-NAC MRI (odds ratio, 8.63) were independently associated with pCR. Residual tumor sizes, as measured using MRI and surgical specimens, sh...

Preoperative breast MRI depicted additional malignancy in US-guided biopsy-confirmed ductal carcinoma in situ, reducing positive surgical margins and repeat surgery rates without affecting the mast... Background The role of preoperative MRI for predicting surgical outcomes in patients diagnosed with ductal carcinoma in situ (DCIS) remains uncertain. Purpose To investigate the associations betwee...

OBJECTIVE. The purpose of this study is to determine the frequency and the malignancy rate of BI-RADS category 3 lesions detected on screening breast ultrasound and to reassess whether they satisfied the requirements of the American College of Radiology Imaging Network (ACRIN) 6666 protocol. MATERIALS AND METHODS. Of 28,796 asymptomatic women who underwent screening mammography during 2 years, 12,187 underwent additional ultrasound as part of the screening. Patients for whom BI-RADS category 3 lesions were seen on the ultrasound were selected. We reviewed the initial ultrasound showing BI-RADS category 3 lesions and mammograms. We also investigated the clinical outcome of these lesions using the reference standard of a combination of pathologic analysis and follow-up for at least 24 months. RESULTS. The frequency of BI-RADS category 3 lesions detected on screening ultrasound was 14.6% (1783/12,187). Of the 1164 patients with a follow-up duration of at least 24 months or whose lesions were biopsied, eight ...

The purpose of this study is to evaluate the use of second-look ultrasonography (US) for investigating additional suspicious lesions detected on preoperative staging magnetic resonance imaging (MRI) for breast cancer. Between September 2008 and August 2010, 1,970 breast MRIs were performed at our medical institution for the evaluation of breast cancer before surgery. Second-look US was recommended for 135 patients with 149 suspicious lesions, following the MRI interpretation, and 108 patients with 121 lesions were included in this study. The detection rate on second-look US, according to the lesion type, diameter, and histopathological outcome, was analyzed. Of the 121 lesions considered in this study, 97 (80.2%) were diagnosed on MRI as masses and 24 (19.8%) as non-mass-like lesions; 105 lesions (86.8%) were correlated and 16 (13.2%) were not correlated with the findings of second-look US. Of the 105 correlated lesions, 29 (27.6%) were proven to be malignant and 76 (72.4%) were benign. Although a greater number of large malignant lesions were correlated on second-look US than small benign lesions, there was no statistically significant difference according to lesion diameter or type, as seen on MRI or pathology. We have concluded that second-look US is a useful diagnostic tool for lesions incidentally detected on breast MRI, as in this study, it could identify 86.8% of the MRI-detected breast lesions.