致密的乳腺组织是乳腺癌的独立危险因素，并降低乳房X光检查的敏感性。乳腺组织致密的患者更有可能出现间期癌症和晚期疾病。成功的乳腺癌筛查结果取决于早期乳腺癌的检测；因此，已经开发了几种补充筛查方式来改善致密乳腺组织中的癌症检测。美国是全世界使用最广泛的补充筛查方式，并已被证明可以显示出更多的乳腺X线隐匿性癌症，这些癌症主要是侵袭性的和淋巴结阴性的。根据美国放射学会的说法，由于乳房 X 光检查的局限性，具有致密乳腺组织的中危女性可能会受益于美国辅助筛查。多项研究表明，手持式超声检查 (HHUS) 和自动乳腺超声检查 (AUS) 在筛查环境中具有可比性。与 HHUS 相比，AUS 的优点包括不依赖操作员、无需正式培训、图像可重复性以及时间比较的能力。然而，AUS 具有独特的功能，可能会导致新用户误报率高和解释时间长。熟悉良性乳房 X 光检查结果和伪影的常见外观、技术挑战和独特的 AUS 特征对于快速、高效和准确的解释至关重要。本文的目标是 (a) 研究 AUS 作为补充筛查方式的作用，以及 (b) 回顾 AUS 解释的亮点和陷阱。 ©RSNA，2023 本文的测验问题可在补充材料中找到。

Dense breast tissue is an independent risk factor for breast cancer and reduces the sensitivity of mammography. Patients with dense breast tissue are more likely to present with interval cancers and higher-stage disease. Successful breast cancer screening outcomes rely on detection of early-stage breast cancers; therefore, several supplemental screening modalities have been developed to improve cancer detection in dense breast tissue. US is the most widely used supplemental screening modality worldwide and has been proven to demonstrate additional mammographically occult cancers that are predominantly invasive and node negative. According to the American College of Radiology, intermediate-risk women with dense breast tissue may benefit from adjunctive screening US due to the limitations of mammography. Several studies have demonstrated handheld US (HHUS) and automated breast US (AUS) to be comparable in the screening setting. The advantages of AUS over HHUS include lack of operator dependence and a formal training requirement, image reproducibility, and ability for temporal comparison. However, AUS exhibits unique features that can result in high false-positive rates and long interpretation times for new users. Familiarity with the common appearance of benign mammographic findings and artifacts, technical challenges, and unique AUS features is essential for fast, efficient, and accurate interpretation. The goals of this article are to (a) examine the role of AUS as a supplemental screening modality and (b) review the pearls and pitfalls of AUS interpretation. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.