Comparison of patient perception and ultrasound scanning duration between radial and conventional meander-like breast ultrasound in a clinical setting

Introduction:

Breast ultrasound (US) plays a key role in the examination of breast abnormalities. To this day, US is usually performed in a meander-like manner (mUS). The alternative radial US technique (rUS) scans the breast in a circle around the mammilla and is mainly used for the examination of intraductal pathologies. We report a single-centre, prospective study evaluating patient preference for either US procedure.

Material and Methods:

MUS and rUS were performed using the same type of US machine, on the same day by two independent examiners. RUS was performed with a 92 mm and mUS with a 50 mm linear probe. Consenting patients stated comfort and preference in a visual analogue scale-based (VAS) questionnaire. VAS values of mUS and rUS were compared using Mann-Whitney U test. Duration of rUS and mUS scanning was monitored and mean examination time was compared using Wilcoxon signed rank test. Patient family- and personal history (HF and PH) were investigated. The association between VAS-ratings and the examination time, the patient's age, the body mass index (BMI), the breast size and the presence or absence of a FH of ovarian-, endometrial- or breast cancer and of a PH of previous breast surgeries or biopsies was assessed in a multivariate linear model.

Results:

RUS was considered significantly more comfortable than mUS (p < 0.001). With a mean scanning time of 13 min for m-US and 7 min for r-US, rUS was significantly faster than mUS (p < 0.01). 49% of the 473 patients filling in the VAS scale-based questionnaire preferred rUS, 44% had no preference, and only 6% stated a preference for mUS. The preference for rUS was associated with a significantly higher comfort during rUS (p < 0.001, Mann-Whitney U test) and the sensation of reduced pressure (p < 0.001, Fisher's exact test). Younger women felt significantly less comfortable during mUS (p = 0.038) but not during rUS (p = 0.67) compared to older women. The Breast size, the women's BMI, a positive FH or PH and the duration of either US had no influence on a woman's comfort during either mUS or rUS.

Conclusion:

Our data confirm that patients associate rUS with increased comfort. In particular, pressure reduction seemed to contribute to a preference for rUS. Replacing conventional mUS by rUS may help to improve patient comfort and thereby the compliance.