Reliability of automated breast ultrasound examination of suspicious breast masses: comparison to handheld breast ultrasound
Gabin Yun1, Mijung Jang1 , Sun Mi Kim1, Hye Shin Ahn2, Bo La Yun1
1Seoul National University Bundang Hospital, seong nam, Korea
2Chung-Ang University Hospital, Seoul, Korea
Corresponding Author: Mijung Jang ,Tel: 031-787-7622, Fax: 031-787-4011, Email:
Received: September 28, 2018;  Accepted: December 23, 2018.  Published online: December 23, 2018.
To assess the reliability of automated breast ultrasound (ABUS) examination of suspicious breast masses by comparison to handheld breast ultrasound (HHUS) with regard to breast imaging reporting and data system (BI-RADS) category assessment, and to investigate the factors affecting category discrepancy.
A total of 135 masses that were assessed as BI-RADS categories 4 and 5 on ABUS and followed by ultrasound (US)-guided core needle biopsy from May 2017 to December 2017 were included in this study. The BI-RADS categories were re-assessed using HHUS. Agreement of BI-RADS categories was evaluated using kappa statistics, and the positive predictive value (PPV) of each examination was also calculated. Further analysis of mammography and US findings that were associated with BI-RADS category discrepancy was performed using logistic regression.
The overall agreement between ABUS and HHUS in all cases was good (79.3%; kappa=0.61, P<0.001). Logistic regression analysis revealed that accompanying suspicious microcalcifications on mammography (odds ratio 4.63; 95% confidence interval 1.83-11.71; P=0.001) and irregular shape on US (odds ratio 5.59, 4.78; 95% confidence interval 1.43-21.83; P=0.013) findings were associated with BI-RADS category discrepancy.
The agreement of BI-RADS category assessment of suspicious breast masses between ABUS and HHUS examination was good. The presence of suspicious microcalcifications on mammography and irregular shape on US findings were factors associated with reduced suspicion as determined by BI-RADS category assessment by ABUS compared to that by HHUS.
Keywords: Automated breast ultrasound; Breast cancer; Breast imaging reporting and data system; Hand-held ultrasound
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