Patient acceptance and implementation of automated breast ultrasound in intensified breast cancer surveillance

Purpose Automated breast ultrasound (ABUS) is a standardized ultrasound technique that may reduce operator dependency compared with hand-held ultrasound. Evidence on patient acceptance and implementation in intensified breast cancer surveillance remains limited. This study evaluated patient acceptance and clinical implementation of ABUS within a certified center of the German Consortium for Hereditary Breast and Ovarian Cancer. Methods In this prospective single-center observational study, women enrolled in an intensified breast cancer surveillance program underwent ABUS examinations and completed standardized questionnaires. Patient-reported outcomes included examination-related discomfort, comparison with mammography, willingness to repeat the examination, and willingness to recommend ABUS. Workflow parameters and changes in acquisition time over repeated examinations were assessed prospectively. Results 73 women contributed 162 ABUS examinations and corresponding questionnaires. Of these, 46/73 (63.0%) carried pathogenic variants in BRCA1, BRCA2, PALB2, or TP53, and 27/73 (37.0%) had a previous breast cancer diagnosis. Median pain score was 0 (IQR 0–1) for both breasts. Among women with previous mammography and an available comparative rating, 56/57 (98.2%) rated ABUS as more comfortable. All 73 participants (100%) were willing to undergo future ABUS examinations and recommend the procedure. Mean acquisition and interpretation times were 31.9 ± 6.2 and 9.95 ± 4.0 min, respectively. Acquisition time decreased significantly with increasing examination number ( β = − 1.72 min/examination; p < 0.001). Conclusions ABUS was associated with high reported patient acceptance and was feasible to integrate into intensified breast cancer surveillance, with improving acquisition efficiency over time.