背景：自动乳腺超声（AB）对描绘西方女性乳腺X线摄影中隐性乳腺癌有良好效果。然而，很少有研究关注亚洲女性的补充AB超声筛查结果。这些女性乳腺密度比西方女性高。目的：评估补充AB超声对基于乳腺X线摄影筛查的亚洲女性乳腺癌检出的表现，包括乳腺密度高和非高的患者。材料和方法：通过回顾数据库，确定在2018年1月至2019年12月期间进行了数字乳腺摄影（DM）和补充AB超声筛查的无症状韩国女性。排除没有足够跟踪、确切的最终诊断或组织病理学结果的女性。比较DM的性能指标和AB US加DM（以下简称AB US plus DM）。主要结果是癌症检出率（CDR），次要结果是敏感性和特异性。根据乳腺密度进行亚组分析。结果：共2785例筛查检查中发现了28例癌症（26例筛查检出的癌症，2例间期癌症）。与DM相比，AB US plus DM在高乳腺密度女性中导致更高的CDR（每1000个检查9.3个，95% CI：7.7、10.3，与每1000个检查6.5个，95% CI：5.2、7.2相比，P＜.001）和更高的敏感性（90.9%，95% CI：77.3、100.0，与63.6%，95% CI：40.9、81.8相比，P＜.001），但特异性降低（86.8%，95% CI：85.2、88.2，与94.6%，95% CI：93.6、95.5相比，P＜.001）。在乳腺密度非高的女性中，AB US plus DM导致更高的CDR（每1000个检查9.5个，95% CI：7.1、10.6，与每1000个检查6.3个，95% CI：3.5、7.1相比，P＜.001），而特异性较低（95.2%，95% CI：93.4、96.8，与97.1%，95% CI：95.8、98.4相比，P＜.001）。结论：在亚洲女性中，将自动乳腺超声与数字乳腺摄影相结合，乳腺密度高和非高的癌症检出率更高，但特异性较低。© RSNA，2023本文章的补充材料可供使用。

Background Automated breast (AB) US effectively depicts mammographically occult breast cancers in Western women. However, few studies have focused on the outcome of supplemental AB US in Asian women who have denser breasts than Western women. Purpose To evaluate the performance of supplemental AB US on mammography-based breast cancer screening in Asian women with dense breasts and those with nondense breasts. Materials and Methods A retrospective database search identified asymptomatic Korean women who underwent digital mammography (DM) and supplemental AB US screening for breast cancer between January 2018 and December 2019. We excluded women without sufficient follow-up, established final diagnosis, or histopathologic results. Performance measures of DM alone and AB US combined with DM (hereafter AB US plus DM) were compared. The primary outcome was cancer detection rate (CDR), and the secondary outcomes were sensitivity and specificity. Subgroup analyses were performed based on mammography density. Results From 2785 screening examinations in 2301 women (mean age, 52 years ± 9 [SD]), 28 cancers were diagnosed (26 screening-detected cancers, two interval cancers). When compared with DM alone, AB US plus DM resulted in a higher CDR of 9.3 per 1000 examinations (95% CI: 7.7, 10.3) versus 6.5 per 1000 examinations (95% CI: 5.2, 7.2; P < .001) and a higher sensitivity of 90.9% (95% CI: 77.3, 100.0) versus 63.6% (95% CI: 40.9, 81.8; P < .001) but a lower specificity of 86.8% (95% CI: 85.2, 88.2) versus 94.6% (95% CI: 93.6, 95.5; P < .001) in women with dense breasts. In women with nondense breasts, AB US plus DM resulted in a higher CDR of 9.5 per 1000 examinations (95% CI: 7.1, 10.6) versus 6.3 per 1000 examinations (95% CI: 3.5, 7.1; P < .001), whereas specificity was lower at 95.2% (95% CI: 93.4, 96.8) versus 97.1% (95% CI: 95.8, 98.4; P < .001). Conclusion In Asian women, the addition of automated breast US to digital mammography showed higher cancer detection rates but lower specificities in both dense and nondense breasts. © RSNA, 2023 Supplemental material is available for this article.