Regina J. Hooley MD, Presenter: Consultant, Guerbet

Jaime Lynn Geisel MD, Abstract Co-Author: Nothing to Disclose

Madhavi Raghu MD, Abstract Co-Author: Consultant, Hologic, Inc

Melissa Angeline Durand MD, Abstract Co-Author: Nothing to Disclose

Cary P. Gross MD, Abstract Co-Author: Nothing to Disclose

Susan Heidi Busch, Abstract Co-Author: Nothing to Disclose

Liane Elizabeth Philpotts MD, Abstract Co-Author: Consultant, Hologic, Inc.

Both whole breast ultrasound (WBUS) and 3D tomosynthesis (DBT) mammograms are being more widely utilized in the United States and both modalities can detect cancers not visualized on conventional digital mammography. The purpose of this study is to determine the performance of WBUS in women with a recent prior normal DBT mammogram.

A retrospective chart review was performed on 1039 consecutive women who underwent handheld WBUS between 10/1/2011 and 9/20/2012 and who had a prior normal DBT mammogram performed within 12 months before the WBUS examination. All WBUS exams were performed by a breast ultrasound technologist and were immediately reviewed and interpreted by a radiologist.

The average patient age was 52.3 years (S.D. +/- 9.5 years, range 27-94). The average time between the mammogram and WBUS was 32 days (639 patients had both exams on the same day). Of the 1039 WBUS exams, 599 were prevalence screenings and 440 were incidence screenings. 906 (87.2%) were BI-RADS 1 or 2, 102 (9.8%) were BI-RADS 3 and 31 (3.0%) were BI-RADS 4. There were no BI-RADS 5 lesions. Ultrasound guided aspiration or biopsy was performed in 38 women, including 10 BI-RADS 3 and 30 BI-RADS 4 lesions. Two BI-RADS 4 lesions were malignant infiltrating ductal carcinomas. Both cancers were found on a prevalence WBUS and both were not seen on DBT, even in retrospect. The overall positive predictive value of BI-RADS 4 lesions was 6.5%. The cancer detection rate was 1.9/1000.

Supplemental WBUS performed in addition to DBT can detect mammographically occult breast cancers, although the rate is lower than previous studies of WBUS performed in addition to conventional mammography

Multiple studies have demonstrated that supplemental WBUS has a cancer detection rate of 3-5/1000, although the performance of WBUS as a supplement to DBT mammography has yet to be determined.

Hooley, R, Geisel, J, Raghu, M, Durand, M, Gross, C, Busch, S, Philpotts, L, Performance of Whole Breast Ultrasound in Women with Dense Breasts Following 3D Tomosynthesis Mammography.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13017257.html