The mammogram is now used in a large scale in screening of breast lesions, and it proved to be effective in the detection of the lesions and so reducing mortality from breast cancer. Exposure to radiation is a major disadvantage of mammogram and recent studies showed about a 43% reduction in screening programs for fear of radiation. Moreover, its sensitivity in lesion detection is much lower in dense breasts. Some studies show low sensitivity down to 50% or less as dense breasts can obscure the tumors and make reading and interpreting the exam difficult and inaccurate. This resulted in increased false-positive lesions and increased number of useless biopsies and so increased costs and increased the patient’s anxiety. About 50% of young females less than 50 years of age have dense breasts and about 1/3 of older females more than 50 years also have dense breasts.
Other screening tools include breast ultra-sonography and breast MRI. Sonography is a low-cost tool for screening and is widely available than MRI, yet it is operator-dependent, time-consuming, and non-reproducible especially in large breasts. ABUS is a new tool to overcome such disadvantages [1].
Both handheld ultrasound (HHUS) and ABUS have very high sensitivity (100% for both) and high specificity (85.0% and 95.0%, respectively). Moreover, ABUS showed a higher diagnostic accuracy (97.1%) than handheld ultrasound (91.4%) for breast neoplasms [2].
ABUS is like the traditional ultrasound using high-frequency sound waves passing and reflected from the breast tissues, but it gives a 3D volume image of the whole breast at once. This is more useful for females with dense breasts as they give better data and allow the radiologists to use different angles and planes for examination and so a better interpretation of the lesions. It also takes much less time than HHUS. ABUS transducer automatically scans both breasts and so operator dependency is much lower than HHUS [3]
Aim of the work
The aim of this study to evaluate the ABUS machine as non-X-ray hazardous tool in early detection of different breast lesion.
Methods
All 25 women underwent breast screening. A supplementary sonography study was performed to all cases with positive findings in mammography. No exclusion criteria. The institution review board approved the study. Written consent was taken from the patients with detailed steps of the procedure.
All patients were submitted to the following: demographic and clinical data collection, including patient’s name, age, and marital status; duration of illness; past history; family history; and provisional diagnosis.
Mammography was performed using a GE Healthcare device with dual-energy acquisitions CEDM “Senographe 2000 D full field digital mammography Essential GE Healthcare.” A full-field system using a detector with flat panel and Csl absorber was used with field size of 19 × 23 and pitch of 100 mm with image matrix = 1914 × 2294.
Technique of digital mammography
Standard views medio-lateral-oblique and cranio-cauda1 views were taken for all patients.
ABUS examination was performed using a GE Healthcare ultrasound device allowing ultrasound waves transmission by high-frequency probe (7–13 MHz) passing through the breast tissues with software- and hardware-specific adaptations for image acquisition and processing (Fig. 1).
Technique of ABUS
The patient lies in supine position. A machine arm that is computer-guided acquired the images through the attached transducer. The images are acquired in rows in a longitudinal manner as well as transverse images. Antero-posterior (AP), lateral, and medial standard views were taken for each breast (Fig. 2). There is ability to add some additional views in some cases as views for axillary tail and special upper quadrants localized views.
Statistical analysis
Analysis of data was done by IBM computer using SPSS (Statistical Program for Social Science version 12). Description of quantitative variables was mean and range. Description of qualitative variables was number and percentage. Chi-square test of independence is used to determine if there is a significant relationship between the variables. Independent t test is used for separate groups of variables.