Document Type : Original Article(s)
Authors
1 Department of Radiology, Faculty of Medicine University, Teknologi MARA, Sungai Buloh, Selangor, Malaysia
2 Department of Biomedical Imaging, University Malaya Research Imaging Centre, Kuala Lumpur, Malaysia
Abstract
Background: Accurate local staging is crucial for breast cancer treatment planning. This study aimed to compare the measurements of tumour size and distance from the nipple using automated breast ultrasound (ABUS) and magnetic resonance imaging (MRI) in a Malaysian cohort.
Method: A retrospective study was conducted on 36 women (49 breast lesions) who underwent both MRI and ABUS. Two breast radiologists independently assessed the anonymized images. Tumour size and distance from the nipple were measured and compared between modalities. Statistical analysis was performed using SPSS version 25.0, by employing student's t-test and kappa analysis, with a significance level of P < 0.001.
Results: The mean tumour size was 27.2 mm on ABUS and 28.3 mm on MRI, with a statistically significant difference (P < 0.001). MRI also measured a significantly greater distance from the nipple (P < 0.001). Inter-reader agreement was excellent for breast density assessment but not for lesion description.
Conclusion: ABUS and MRI demonstrate comparable performance in preoperative breast cancer staging, although MRI tends to give a larger tumour size and distance measurement from the nipple. Both modalities can contribute to local staging, aiding treatment decisions.
Highlights
Marlina Tanty Ramli Hamid (google scholar)
Nazimah Ab Mumin(google scholar)
Keywords
Main Subjects
How to cite this article:
Ramli Hamid MT, Abdul Hamid S, Ab Mumin N, Rahmat K. A comparative study of automated breast ultrasound and magnetic resonance imaging for local breast cancer staging in Malaysia. Middle East J Cancer. 2026; 17(2): 135-43. doi: 10.30476/mejc.2025.104422.2180.
- Htay MNN, Donnelly M, Schliemann D, Loh SY, Dahlui M, Somasundaram S, et al. Breast cancer screening in Malaysia: A policy review. Asian Pac J Cancer Prev. 2021;22(6):1685-93. doi: 10.31557/ APJCP.2021. 22.6.1685. PMID: 34181322; PMCID: PMC8418850.
- Ferlay J, Colombet M, Soerjomataram I, Parkin DM, Piñeros M, Znaor A. Cancer statistics for the year 2020: An overview. Int J Cancer. 2021. doi: 10.1002/ijc. 33588. Epub ahead of print. PMID: 33818764.
- Zhu H, Doğan BE. American Joint Committee on cancer's staging system for breast cancer, Eighth edition: Summary for clinicians. Eur J Breast Health. 2021;17(3):234-8. doi: 10.4274/ejbh. galenos.2021. 2021-4-3. PMID: 34263150; PMCID: PMC8246053.
- Teichgraeber DC, Guirguis MS, Whitman GJ. Breast cancer staging: updates in the AJCC cancer staging manual, 8th edition, and current challenges for radiologists, from the AJR special series on cancer staging. AJR Am J Roentgenol. 2021;217(2):278-90. doi: 10.2214/AJR.20.25223. PMID: 33594908.
- Washington I, Palm RF, White J, Rosenberg SA, Ataya D. The role of MRI in breast cancer and breast conservation therapy. Cancers (Basel). 2024;16(11): 2122. doi: 10.3390/cancers16112122. PMID: 38893241; PMCID: PMC11171236.
- Eisen A, Fletcher GG, Fienberg S, George R, Holloway C, Kulkarni S, et al. Breast magnetic resonance imaging for preoperative evaluation of breast cancer: A systematic review and meta-analysis. Can Assoc Radiol J. 2024;75(1):118-35. doi: 10.1177/0846537 1231184769.PMID: 37593787.
- Thompson JL, Wright GP. The role of breast MRI in newly diagnosed breast cancer: An evidence-based review. Am J Surg. 2021;221(3):525-8. doi: 10.1016/j.amjsurg.2020.12.018.PMID: 33339617.
- Rahmat K, Mumin NA, Hamid MTR, Hamid SA, Ng WL. MRI breast: Current imaging trends, clinical applications, and future research directions. Curr Med Imaging. 2022;18(13):1347-61. doi: 10.2174/ 1573405618666220415130131. PMID: 35430976.
- Girometti R, Tomkova L, Cereser L, Zuiani C. Breast cancer staging: Combined digital breast tomosynthesis and automated breast ultrasound versus magnetic resonance imaging. Eur J Radiol. 2018;107:188-95. doi: 10.1016/j.ejrad.2018.09.002.PMID: 30292265.
- Schmachtenberg C, Fischer T, Hamm B, Bick U. Diagnostic performance of automated breast volume scanning (ABVS) compared to handheld ultrasonography with breast MRI as the gold standard. Acad Radiol. 2017;24(8):954-61. doi: 10.1016/j.acra. 2017.01.021.PMID: 28336007.
- Vourtsis A, Kachulis A. The performance of 3D ABUS versus HHUS in the visualisation and BI-RADS characterisation of breast lesions in a large cohort of 1,886 women. Eur Radiol. 2018;28(2):592-601. doi: 10.1007/s00330-017-5011-9.PMID: 28828640.
- Jia M, Lin X, Zhou X, Yan H, Chen Y, Liu P, et al. Diagnostic performance of automated breast ultrasound and handheld ultrasound in women with dense breasts. Breast Cancer Res Treat. 2020;181(3):589-97. doi: 10.1007/s10549-020-05625-2.PMID: 32338323.
- Giger ML, Inciardi MF, Edwards A, Papaioannou J, Drukker K, Jiang Y, et al. Automated breast ultrasound in breast cancer screening of women with dense breasts: Reader study of mammography-negative and mammography-positive cancers. AJR Am J Roentgenol. 2016;206(6):1341-50. doi: 10.2214/AJR.15.15367. PMID: 27043979.
- Rahmat K, Ab Mumin N, Ng WL, Mohd Taib NA, Chan WY, Ramli Hamid MT. Automated breast ultrasound provides comparable diagnostic performance in opportunistic screening and diagnostic assessment. Ultrasound Med Biol. 2024;50(1):112-8. doi: 10.1016/j.ultrasmedbio.2023.09.011.PMID: 37839984.
- Łuczyńska E, Pawlak M, Popiela T, Rudnicki W. The role of ABUS in the diagnosis of breast cancer. J Ultrason. 2022;22(89):76-85. doi: 10.15557/JoU.2022. 0014. PMID: 35811591; PMCID: PMC9231518.
- Mann RM, Balleyguier C, Baltzer PA, Bick U, Colin C, Cornford E, Breast MRI: EUSOBI recommendations for women's information. Eur Radiol. 2015;25(12): 3669-78. doi: 10.1007/s00330-015-3807-z. PMID:26002130; PMCID: PMC4636525.
- Wang SY, Long JB, Killelea BK, Evans SB, Roberts KB, Silber A, et al. Preoperative breast magnetic resonance imaging and contralateral breast cancer occurrence among older women with breast cancer. J Clin Oncol. 2016; 34(4):321-8. doi: 10. 1200/JCO. 2015.62.9741.PMID: 26628465; PMCID: PMC 4872032.
- Mann RM, Cho N, Moy L. Breast MRI: State of the art. Radiology. 2019;292(3):520-36. doi: 10.1148/ radiol.2019182947. PMID: 31361209.
- Boca Bene I, Ciurea AI, Ciortea CA, Dudea SM. Pros and cons for automated breast ultrasound (ABUS): A narrative review. J Pers Med. 2021;11(8): 703. doi: 10.3390/jpm11080703. PMID: 34442347; PMCID: PMC8400952.
- Wang X, Huo L, He Y, Fan Z, Wang T, Xie Y, et al. Early prediction of pathological outcomes to neoadjuvant chemotherapy in breast cancer patients using automated breast ultrasound. Chin J Cancer Res. 2016;28(5):478-85. doi: 10.21147/j.issn. 1000-9604.2016.05.02. PMID: 27877006; PMCID: PMC5101221.
- D'Angelo A, Rinaldi P, Belli P, D'Amico R, Carlino G, Grippo C, et al. Usefulness of automated breast volume scanner (ABVS) for monitoring tumor response to neoadjuvant treatment in breast cancer patients: preliminary results. Eur Rev Med Pharmacol Sci. 2019;23(1):225-31. doi: 10.26355/eurrev_201901 _16768. PMID: 30657564.
- Panico C, Ferrara F, Woitek R, D'Angelo A, Di Paola V, Bufi E, et al. Staging breast cancer with MRI, the T. A key role in the neoadjuvant setting. Cancers (Basel). 2022;14(23):5786. doi: 10.3390/ cancers14235786. PMID: 36497265; PMCID: PMC9739275.
- Lagendijk M, Vos EL, Ramlakhan KP, Verhoef C, Koning AHJ, van Lankeren W, et al. Breast and tumour volume measurements in breast cancer patients using 3-D automated breast volume scanner images. World J Surg. 2018;42(7):2087-93. doi: 10.1007/s00268-017-4432-6. PMID: 29299647; PMCID: PMC5990576.
- Taydaş O, Durhan G, Akpınar MG, Demirkazık FB. Comparison of MRI and US in tumor size evaluation of breast cancer patients receiving neoadjuvant chemotherapy. Eur J Breast Health. 2019;15(2):119-24. doi: 10.5152/ejbh.2019.4547. PMID: 31001614; PMCID: PMC6456278.
- D'Angelo A, Gatta G, Di Grezia G, Mercogliano S, Ferrara F, Trombadori CML et al. Supine versus prone 3D abus accuracy in breast tumor size evaluation. Tomography. 2022;8(4):1997-2009. doi: 10.3390/tomography 8040167. PMID: 36006065; PMCID: PMC9413588.
- Chen JH, Lee YW, Chan SW, Yeh DC, Chang RF. Breast density analysis with automated whole-breast ultrasound: Comparison with 3-D magnetic resonance imaging. Ultrasound Med Biol. 2016;42(5):1211-20. doi: 10.1016/j.ultrasmedbio.2015.12.015.PMID:26831342.
- Allajbeu I, Hickman SE, Payne N, Moyle P, Taylor K, Sharma N, et al. Automated breast ultrasound: Technical aspects, impact on breast screening, and future perspectives. Curr Breast Cancer Rep. 2021; 13(3):141–50.
)