Glenys Da Costa MBBS, Abstract Co-Author: Nothing to Disclose

Janice S. Sung MD, Presenter: Nothing to Disclose

Christopher E. Comstock MD, Abstract Co-Author: Nothing to Disclose

D. David Dershaw MD, Abstract Co-Author: Nothing to Disclose

Elizabeth A. Morris MD, Abstract Co-Author: Nothing to Disclose

To evaluate the added cancer detection and false positive rate of a technologist-performed handheld screening breast ultrasound program

IRB approved retrospective review was performed on 890 consecutive women who underwent screening hand held high resolution breast ultrasound performed by a breast ultrasound technologist between October 2011-February 2013. Radiologist performed targeted ultrasound only in cases if a solid or indeterminate lesion was identified by the sonographer. Clearly benign findings, such as simple and complicated cysts, were neither recorded nor re-evaluated by the radiologist. 63 probably benign or suspicious lesions were identified.

Of the 890 women, 299 (34%) were pre-menopausal and 591 (66%) peri/post-menopausal. 288 (32%) had a personal history of breast cancer, 67(8%) a prior biopsy proven high-risk lesion, and 592(67%) a family history of breast cancer. 769/875(88%) patients had a mammogram within 6 months of the ultrasound. Breast density was predominantly fatty in 31 (3%), scattered fibroglandular densities in 171 (20%), heterogeneously dense in 521 (60%), and extremely dense in 152(17%). 837 (94%) studies were assessed as BI-RADS 1 or 2, 20 (2%) as BI-RADS 3, and 43 (5%) as either BI-RADS 4 or 5. Biopsy was performed for 39/43 suspicious lesions, yielding malignancy in 3/39 (PPV 8%). The cancers were all solid masses between 1.0-1.3 cm in size in heterogeneously dense breasts. Of the 3 women with cancers, 2 had a personal history of breast cancer and the other had no additional risk factor. 2 had a negative mammogram within 5 weeks of the ultrasound and the third within 7 months. The overall cancer detection rate was 3.4 cancers per 1000 women.

Technologist performed handheld screening breast ultrasound demonstrates a cancer detection rate (3.4/1000) and PPV (8%) of biopsy similar to that reported for physician performed ultrasound screening.

Screening breast ultrasound performed by technologists is a feasible alternative to physician performed ultrasound screening, reducing radiologists time and cost.

Da Costa, G, Sung, J, Comstock, C, Dershaw, D, Morris, E, Initial Experience of Technologist Performed Whole Breast Screening Ultrasound.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13020945.html