明显缺乏关于基于超声的乳腺癌筛查策略的有效性的有力证据，特别是在致密乳房患病率较高的人群中。我们的研究通过评估此类策略在中国女性中的有效性来弥补这一差距，从而丰富了为乳腺组织致密女性确定最有效筛查方法的证据基础。这项前瞻性队列研究于 2018 年 10 月至 2022 年 8 月在华中地区进行。招募了 8996 名年龄在 35-64 岁的女性，分为两个年龄组（35-44 岁和 45-64 岁）。参与者使用手持式超声（HHUS）和自动乳腺超声系统（ABUS）进行乳腺癌筛查，年龄较大的组还接受全视野数字乳房X线摄影（FFDM）。采用乳腺影像报告和数据系统（BI-RADS）进行图像判读，BI-RADS 4/5 提示结果异常，需要进行活检； BI-RADS 3 需要通过初步筛选策略在 6-12 个月内进行随访； BI-RADS 1/2 为阴性。在筛查的女性中，发现乳腺癌 29 例，其中 35-44 岁组 4 例（1.3‰），45-64 岁组 25 例（4.2‰）。岁年龄组。在较年轻的年龄组中，HHUS 和 ABUS 表现同样出色，其 AUC 值没有显着差异（0.8678 vs. 0.8679，P > 0.05）。对于老年组，ABUS 作为独立策略 (AUC 0.9935) 和两种补充筛查方法（HHUS 联合 FFDM，AUC 0.9920；ABUS 联合 FFDM，AUC 0.9928）优于单独使用 FFDM（AUC 0.8983，P < 0.05）。然而，单独使用HHUS和单独使用FFDM之间没有显着差异（AUC 0.9529 vs. 0.8983，P > 0.05）。研究结果表明，HHUS和ABUS作为独立的乳腺癌筛查策略均表现出较强的性能，其中ABUS表现出优越的潜力。然而，FFDM 与这些超声技术的集成并没有显着提高筛查过程的整体有效性。版权所有 © 2024 大学放射科医生协会。由爱思唯尔公司出版。保留所有权利。

There is a notable absence of robust evidence on the efficacy of ultrasound-based breast cancer screening strategies, particularly in populations with a high prevalence of dense breasts. Our study addresses this gap by evaluating the effectiveness of such strategies in Chinese women, thereby enriching the evidence base for identifying the most efficacious screening approaches for women with dense breast tissue.Conducted from October 2018 to August 2022 in Central China, this prospective cohort study enrolled 8996 women aged 35-64 years, divided into two age groups (35-44 and 45-64 years). Participants were screened for breast cancer using hand-held ultrasound (HHUS) and automated breast ultrasound system (ABUS), with the older age group also receiving full-field digital mammography (FFDM). The Breast Imaging Reporting and Data System (BI-RADS) was employed for image interpretation, with abnormal results indicated by BI-RADS 4/5, necessitating a biopsy; BI-RADS 3 required follow-up within 6-12 months by primary screening strategies; and BI-RADS 1/2 were classified as negative.Among the screened women, 29 cases of breast cancer were identified, with 4 (1.3‰) in the 35-44 years age group and 25 (4.2‰) in the 45-64 years age group. In the younger age group, HHUS and ABUS performed equally well, with no significant difference in their AUC values (0.8678 vs. 0.8679, P > 0.05). For the older age group, ABUS as a standalone strategy (AUC 0.9935) and both supplemental screening methods (HHUS with FFDM, AUC 0.9920; ABUS with FFDM, AUC 0.9928) outperformed FFDM alone (AUC 0.8983, P < 0.05). However, there was no significant difference between HHUS alone and FFDM alone (AUC 0.9529 vs. 0.8983, P > 0.05).The findings indicate that both HHUS and ABUS exhibit strong performance as independent breast cancer screening strategies, with ABUS demonstrating superior potential. However, the integration of FFDM with these ultrasound techniques did not confer a substantial improvement in the overall effectiveness of the screening process.Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.