Breast Mass Diagnosis with B-Mode Ultrasound: Insights from JABTS BC-01

This study introduces a simplified B-mode ultrasound diagnostic flowchart tailored for identifying solid breast masses, developed as part of the JABTS BC-01 study. Breast ultrasound has become a cornerstone in breast cancer diagnosis due to advances like tissue harmonic imaging and elastography. However, standardized diagnostic criteria remain lacking. This multicenter study, conducted across 22 hospitals in Japan, focused on creating a user-friendly diagnostic tool for beginners in breast ultrasonography. Researchers analyzed 1045 solid breast masses (495 malignant, 550 benign), employing multivariate analysis to identify significant diagnostic markers, including shape, margins, echogenic halo, mammary gland interface interruption, and depth-to-width ratio. The findings informed the development of a novel flowchart to differentiate between benign and malignant lesions, aiding decisions on recommending biopsy or observation. The sensitivity and specificity of the new flowchart were comparable to expert assessments, making it a practical tool for clinical use. Unlike previous complex models, this flowchart is easy to implement and is anticipated to improve diagnostic accuracy and training outcomes for new practitioners. By addressing gaps in existing recall criteria, this research enhances diagnostic capabilities in routine breast cancer evaluations. The study also underscores the importance of centralized interpretation by expert panels to maintain consistency and reliability.