Findings in the Journal of the American College of Radiology provide the strongest evidence to date supporting automated breast ultrasound for supplemental screening of women with dense breasts, overcoming key drawbacks of handheld ultrasound

October 8, 2026 – A new study in the Journal of the American College of Radiology, published by Elsevier, has found that automated breast ultrasound (ABUS) and handheld ultrasound (HHUS) had similar cancer detection rates in women with dense breasts, while ABUS had a lower false-positive rate. It demonstrates that ABUS is a viable alternative to HHUS and can expand supplemental ultrasound screening capacity at radiology clinics.

There is increasing demand for ultrasound screening in addition to mammography following the enactment of state laws and federal rules requiring radiology clinics to inform women with dense breasts about the limitations of mammography. Because dense tissue and lesions both appear white on a mammogram, abnormalities can more easily go undetected.

HHUS has long been available for breast imaging but has drawbacks related to operator dependency and a lack of reproducibility. In 2012, ABUS was approved to conduct breast cancer screening as an adjunct to screening mammography, and it remains an emerging technology in screening for breast cancer.

While prior studies have evaluated ABUS and HHUS separately, as far as the investigators are aware, this is the first study directly comparing the screening performance of ABUS versus HHUS in clinical practice in the United States.

The researchers collected clinical data within three diverse registries of the Breast Cancer Surveillance Consortium (BCSC) and analyzed abnormal interpretation rates, short-interval follow-up (SIFU) recommendation rates, and their associated cancer detection and false-positive rates.

Across the three BCSC registries, there were a total of 25,328 screening ultrasound examinations (4,218 ABUS and 21,110 screening HHUS) included in these analyses, conducted among 21,446 women, and interpreted by 98 radiologists across 27 facilities.

“ABUS was associated with a lower abnormal interpretation rate and a lower false-positive initial assessment rate compared with HHUS,” explains lead investigator Garth H. Rauscher, PhD, Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, and University of Illinois Cancer Center, Chicago, IL. “There were no apparent differences in cancer detection rate, biopsy recommendation rate, or false-positive biopsy recommendation rate.”

The findings of the study suggest that ABUS is associated with less additional imaging and SIFU recommendations, while maintaining the same cancer detection rate.

“The results of our study provide the strongest evidence to date supporting the use of ABUS as an alternative to HHUS for supplemental screening of women with dense breasts,” concludes senior author Brian L. Sprague, PhD, Co-Leader, Population Sciences and Cancer Outcomes Program, University of Vermont Cancer Center, Department of Surgery, University of Vermont, Burlington, VT.