Study on ABUS Applicability for Rural Women With Low Health Resources in China-Large-Scale Population, Non-Opportunistic Screening.

Abstract

Objectives: Comparing the screening performance of different breast cancer screening methods and exploring the applicability of automated breast ultrasonography (ABUS) in rural areas with low health resources in China.

Methods: Women aged 35-64 underwent hand-held ultrasonography (HHUS) and ABUS in Zezhou County, Jincheng City, Shanxi Province, China from 2018 to 2021. Additionally, women aged 45-69 were also screened with mammography (MG). We compared the 3 methods' cancer detection rates, diagnostic accuracy, and overall screening performance, stratified by age groups and breast density. The chi-square test was used to analyze indicators such as sensitivity, specificity, and referral rate.

Results: The mean age of the 9100 women studied was 45 ± 6.42 years, and 25 cases of breast cancer were identified (2.72‰). The proportion of dense breasts is higher among women aged 45-64 years (67.52%). Compared to the non-dense breast group, the detection rate of breast cancer by MG is significantly reduced in the dense breast group (3.42‰ versus 1.97‰). The diagnostic accuracy rate of ABUS and HHUS for lesions is higher than that of MG (P < .05). The kappa coefficient indicates moderate agreement in diagnostic results between HHUS and ABUS. However, the agreement between HHUS/ABUS and MG is poor. There were no statistical differences in sensitivity and specificity among the 3 screening methods. The referral rate and NNR for ultrasound were lower than those for MG (P < .05), but there were no statistically significant differences between ABUS and HHUS.

Conclusions: Among women with denser breasts, ultrasound has a higher diagnostic accuracy rate compared to MG, and it avoids unnecessary biopsies. Compared to HHUS, ABUS can diagnose malignant tumors more objectively and standardized.