Automated Breast Ultrasound (ABUS)

Automated Breast Imaging (ABUS) is a quick exam that uses sound waves and a wide transducer to scan the entire breast and create hundreds of 3D images of the tissue. The resulting 3D images can be a useful reference point for radiologists during future visits, comparing tissue and composition.

During the appointment, your technologist will ask you to lie on the exam table and will apply a warm, water-based gel or cream over your breast. A wide rectangular transducer will be pressed against your entire breast, automatically scanning the area with minimal discomfort.

Watch the ABUS Patient Exam Video

Hand-Held Ultrasound (HHUS)

Hand-Held Ultrasound (HHUS) is an essential tool in modern breast cancer screening, particularly for individuals with heterogeneously or extremely dense breast tissue (classification C or D). HHUS involves the use of a portable ultrasound device operated by a highly trained technologist who scans both breasts entirely.

During a Hand-Held Ultrasound, your technologist will apply a warm, water-based gel directly on your skin and use a small transducer to bilaterally screen both breasts entirely. Compared to an ABUS, the pressure from an HHUS is more targeted, as the technologist moves the transducer across both breasts.

HHUS provides several benefits that make it an excellent option for supplemental screening, including:

  • Increased sensitivity in detecting cancer in dense breasts.

  • Doppler imaging to view vascularity in the tissue, which can help in diagnosis.

ABUS vs. HHUS

Both forms of supplemental imaging have been proven to increase breast cancer detection significantly. From a patient’s perspective, the main differences between ABUS and HHUS are:

  • The pressure from ABUS is applied across the entire breast at once. HHUS is a more targeted pressure that moves around the breast throughout the exam.

  • The ABUS transducer may interfere with patients who have pacemakers or similar devices, potentially leaving HHUS as a more viable alternative.

  • HHUS transducers are currently offered at more MIC clinics than ABUS, which may mean booking your appointment at a location that is closer to home or more convenient.

  • ABUS exams take approximately 15 minutes to complete. Conversely, HHUS can last anywhere from 5 to 30 minutes, depending on the patient and their tissue composition. More often, HHUS exams tend to take longer than ABUS.

Diagnostic Ultrasound Exams

Following your screening mammogram, your radiologist or your healthcare practitioner may want to look more closely at a targeted area in your breast tissue with a diagnostic breast ultrasound. Your practitioner may also request a diagnostic ultrasound if you have a lump or you are having pain and tenderness that is not usual for you.

During a diagnostic ultrasound exam, your technologist will place a warm, water-based gel directly on your skin and then use a small transducer or probe to pass over the area. The transducer transmits high-frequency sound waves through the gel into the body. The transducer collects the sounds that bounce back, and a computer then uses those sound waves to create an image.

 

Breast Ultrasound FAQs

Breast density has nothing to do with the size of your breasts or the way they feel. Dense breasts can feel soft, lumpy, or firm, and so can larger, fatty breasts.
The only way to find out if you have dense breasts is by having a mammogram. Our radiologist will examine the images from the mammogram and classify your breasts using the breast density classification system. Our team will note your breast tissue composition on your report, which is sent to your healthcare practitioner after your appointment.
Yes. Breast density can change over time, so it is important to follow your healthcare practitioner’s screening recommendations consistently.
In Alberta, about 45% of patients who undergo screening mammography have dense breasts.
The ability to detect cancer has been proven to be equivalent between technologist-performed ultrasound and automated ultrasound. ABUS provides a full 3D picture of the breast, which can be used as a reference for future visits to identify any changes. HHUS allows the technologist to add Doppler images to assess for vascularity. The benefits of each modality are relative and do not adversely affect image interpretation.
We aim to streamline the imaging experience for patients by scheduling mammography and supplemental ultrasound screening on the same day. You may be scheduled for HHUS instead of ABUS because of your mammography appointment date. Switching between ABUS and HHUS is of no detriment, as both imaging studies are proven to be equivalent for cancer detection.
You do not have to remain consistent from appointment to appointment. Either supplemental ultrasound screening method has been proven to improve cancer detection rates significantly. Some women find the pressure applied during ABUS to be uncomfortable, so they may consider HHUS at their next appointment. Additionally, women with pacemakers are excluded from ABUS screening due to the presence of a magnet in the ABUS machine, making HHUS a suitable alternative.
No. ABUS/HHUS should be used in conjunction with screening mammography, not as a replacement. Together, the multimodality imaging process provides a complete picture, ensuring the most accurate breast health assessment for patients.
No. Patients cannot self-refer for an ABUS/HHUS as it is not outlined in the Screening for Life provincial program. Therefore, patients need a requisition from their practitioner to book an ABUS/HHUS. Patients are only allowed to self-refer for screening mammography exams provided they meet the right criteria.