Diagnostic value of combined automated breast ultrasound system and conventional two-dimensional ultrasound for intraductal breast lesions

To explore the clinical value of Automated Breast Ultrasound System (ABUS) combined with two-dimensional ultrasound for intraductal breast lesions, and to provide imaging evidence for preoperative benign and malignant differentiation. Patients with pathologically confirmed intraductal breast lesions hospitalized in our hospital from April 2025 to April 2026 were enrolled. All subjects underwent two-dimensional ultrasound and ABUS examination. Ultrasonographic imaging features were compared between benign and malignant groups. Univariate and multivariate logistic regression were used to screen independent risk factors of malignant lesions and establish a combined diagnostic model. ROC curves were drawn to compare the diagnostic efficiency of different detection schemes. A total of 200 patients were enrolled, including 132 benign cases and 68 malignant cases. The malignant group had significantly higher incidences of irregular shape, microcalcification, abundant blood flow, duct dilatation ≥ 5 mm, convergence sign, nipple-oriented lesion extension and marginal spiculation or angulation ( P < 0.05). Multivariate logistic regression confirmed seven independent risk factors for malignancy ( P < 0.05): irregular lesion morphology, microcalcification, Adler grade II–III blood flow, duct dilatation ≥ 5 mm, convergence sign, lesion extending toward the nipple and spiculation/angulation. The combined model had an AUC of 0.90, superior to standalone two-dimensional ultrasound (AUC = 0.81) and single ABUS (AUC = 0.86), with sensitivity of 90.7% and specificity of 89.2%. The combination of ABUS and conventional two-dimensional ultrasound yields favorable preoperative differentiation performance for intraductal breast lesions, elevating diagnostic accuracy and offering objective imaging evidence for individualized clinical decision-making in this single-center cohort.