Imaging studies

Mammograms
Standard cranio-caudal (CC) and medio-lateral oblique (MLO) views of each breast were available for all cases. If implants were present, displacement views were included. Original analog films (66 cases) or prints of digital films (36 cases) were used for review. All cases used in the study provided informed consent, and the protocol was approved by the Institutional Review Boards at each hospital, or The Western Institutional Review Board [9].

AWBUs
Automated whole-breast ultrasound (AWBU) is a computer-based system for performing, recording, and reading whole-breast ultrasound examinations similar in appearance to 2D freehand imaging (SonoCine, Reno, NV). Images were collected with 7- to 12-MHz multi-frequency transducers. The transducer is attached to a computer-guided mechanical arm that acquires images in CC rows overlapping 7 to 10 mm insuring complete coverage of both breasts. Images are collected approximately 0.8 mm apart. The AWBU software creates a ciné loop for review of approximately 3,000 images, simulating real-time imaging. The Windows®-based reading station uses a high-definition 1,600 × 1,200 monitor and special software to increase cancers’ conspicuity. The AWBU procedure was described more fully in a previous publication [9].