First, the doctor that told you about the radiation with ultrasound is dead wrong. Automated whole breast ultrasound (ABUS) is also referred to as automated breast volume scanner (ABVS). They are essentially the same thing but different manufacturers of the equipment like to distinguish their products and techniques. Both are forms of ultrasound and have no ionizing radiation at all. Zero. Period.
Now that that’s out of the way, ultrasound of the breast has recently been shown to be useful in detecting some cancers that mammography may not show.
Note, please keep in mind there are many cancers that will definitely not show up on breast ultrasound and therefore screening for breast cancer with ultrasound alone should never be done because cancers will definitely be missed.
While ultrasound can be useful for screening for breast cancer, one problem with the traditional method (ultrasound tech or doctor holds probe in hand and moves it around to look at the breast tissue) is that it can take a long time. Many complete and thorough exams can take 30 minutes or even an hour depending on the size of the breast, complexity of breast tissue, and experience of the ultrasound technologist or doctor.
Another problem with the traditional ultrasound method is that the quality of the exam completely depends on the ability of the ultrasound technologist or doctor. Some people are good at it, some are not. I have seen large cancers completely missed after 30 minutes of scanning only to be found 30 seconds later by a different technologist or physician coming behind to re-scan the patient.
ABUS/ABVS makes the traditional ultrasound more reliable and shorter. While it cannot replace (and in many aspects will never be as good as the expert performing the traditional ultrasound), it makes using ultrasound to screen for breast cancer more realistically feasible in today’s world.
So should everyone be screened with automated breast ultrasound AND mammography? The answer as of now (according to breast practice in line with what the research has shown) is ‘NO’. While it is true that more cancer will be detected, the one problem with screening breast ultrasound is that it picks up many abnormal appearing areas in the breast that do not turn out to be breast cancer. In other words, it’s very likely that ultrasound will find something in the breast that needs to be biopsied because of the way it looks, but it turns out NOT to be breast cancer.
As of now, the benefit of the extra cancer detection from screening with ultrasound only seems to outweigh the risks of biopsy for patients that have a higher risk for breast cancer such as strong family history or dense breast tissue.
Anyone concerned of the above should talk with their primary care doctor.
Ryan Polselli, MD, Diplomate of the American Board of Radiology, Fellowship Trained Breast Imaging Radiologist.
Please note, this is intended for general informational purposes only and is not intended to be medical advice.