Automated breast ultrasound in breast screening: UK insights from the BRAID trial

This article provides a comprehensive overview of the role and implementation of automated breast ultrasound (ABUS) in breast cancer screening, particularly for women with dense breast tissue.

ABUS is emerging as a valuable adjunct to mammography in breast cancer screening, especially for dense breast tissue. Dense breasts not only reduce mammographic sensitivity but also increase cancer risk. ABUS offers a reproducible, radiation-free and contrast-free imaging alternative, with standardised acquisition and interpretation workflows that enhance consistency and efficiency.

Insights from the UK-wide BRAID trial highlight ABUS’s clinical and operational benefits. It demonstrated improved cancer detection rates and lower recall rates compared to contrast-enhanced techniques, while maintaining high patient acceptability. Scan and reading times significantly decreased with experience and protocol optimisation.

ABUS can be a cost-effective alternative to contrast-enhanced techniques, especially in low resource settings, with lower incremental cost effectiveness ratios than MRI. While it lacks biopsy and axillary assessment capabilities, integration with AI and computer-aided detection is improving diagnostic accuracy and reducing interpretation time. As evidence grows, ABUS shows promise for more equitable and effective breast cancer screening across diverse healthcare environments.

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