Thursday, December 5 | 11:20 a.m.-11:30 a.m. | SSQ01-06 | Arie Crown Theater
In this presentation, Yale University researchers will discuss how supplemental whole-breast ultrasound performed in addition to digital breast tomosynthesis (DBT) can detect cancers DBT misses.Dr. Regina Hooley and colleagues conducted a review of 1,039 women who had handheld whole-breast ultrasound exams between October 2011 and September 2012, and who had prior normal DBT mammograms performed within 12 months before the ultrasound exams.
Of the 1,039 ultrasound exams, 599 were prevalence screenings and 440 were incidence screenings, according to the researchers. Of all lesions found, 87.2% were BI-RADS 1 or 2, 9.8% were BI-RADS 3, and 3% were BI-RADS 4; there were no BI-RADS 5 lesions.
Two of the BI-RADS 4 lesions were malignant infiltrating ductal carcinomas. Both were identified on a prevalence whole-breast ultrasound, and both were not seen on DBT, even in retrospect, the group said.
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
