Automated Whole Breast Ultrasound (AWBUS)

For women with dense breasts and/or breast implants, Automated Whole Breast Ultrasound (AWBUS) is the latest technology for breast cancer detection. AWBUS is a supplementary ultrasound examination of both breasts that can find small cancers that mammography may miss. It is not a replacement for screening mammography. However, mammography is not a perfect examination for women with dense breasts. AWBUS can increase confidence in your diagnoses.

Studies show that an ultrasound examination, in conjunction with a mammogram, can find more cancers in women with dense breasts than by mammography alone. Our goal is to find cancers when they are small.

Research shows why AWBUS is so extraordinary:

  • Early detection can increase breast cancer survival
  • Finding cancers when they are small saves lives
  • More than 40 percent of women have dense-breast tissue
  • AWBUS, in addition to mammography, may find as many as 100% more cancers in women with dense breasts than can be found by mammography alone.

What to expect during an AWBUS examination:
An AWBUS examination uses sound waves and is safe for unborn children and therefore, safe for your breast tissue.

  • It is painless
  • No injections
  • Requires no breast compression
  • Requires no radiation
  • Takes about 20-30 minutes
  • Your exam is permanently recorded for your physician’s review and follow-up
  • Your exam is interpreted by a radiologist and a report is sent to your referring provider

If your mammogram shows you have dense breasts, you may want to consider an AWBUS examination in addition to your mammogram.

To learn more about Automated Whole Breast Ultrasound at Covenant HealthCare, refer to the information below or call our Breast Health Center at 989.583.6279

What is breast density?
Approximately 40% of women have dense breasts. Breast density refers to the amount of fat and tissue in the breast as seen on a mammogram, which is graded from 1-4. Women with a breast density of 3-4 are at a significantly increased risk of developing breast cancer. A dense breast has more tissue than fat. Younger women usually have dense breasts.
As women get older, their breasts become less dense and more fatty. After menopause, breast tissue of most women is replaced by fat. Some older women who use postmenopausal hormones may have higher breast density until they stop using hormones.

Why is breast density important?
Women with dense breasts have an increased risk of breast cancer. It is not known at this time what it is about dense breast tissue that increases a woman’s risk for breast cancer. Dense breast tissue also makes it harder for the radiologist to see cancer on mammograms. On a mammogram, cancer shows up white, but so does the tissue in a dense breast. Radiologists face similar problems detecting cancer on mammograms of women with breast implants. The cancer again shows up as white against the white background of their implant. New, advanced breast imaging options help radiologists detect smaller cancers within dense breast tissue and in women with implants.

Screening for women with dense breasts
Both dense breasts and implants make it difficult to detect small breast cancers on a mammogram, when they are easiest to treat. As a result, mammograms may not be as effective in women with dense breasts. While overall mammographic sensitivity for the detection of breast cancer is often quoted at 85-90%, this percentage drops to 50% in women with extremely dense breast.

New technology is now available to improve detection of cancer in women with dense breasts.

  • Automated Whole Breast Ultrasound screenings are most advantageous for women with a breast density grade of 3-4. Small cancers usually appear dark against the white background of dense breast tissue with this method, making the cancer more visible. Studies indicate that in conjunction with a mammogram, this full breast ultrasound screen can double the cancer detection rate in dense-breasted women and in women with implants.
  • 3D Tomosynthesis is most beneficial for women with a breast density grade of 2-3. 3D Tomosynthesis improves visualization of calcifications and small cancers that can be hidden by overlapping tissue. Studies indicate this method not only increases the probability of early detection, but also decreases false positive mammograms.
  • MRI – women with increased risk factor, such as a 15-20% lifetime risk for breast cancer and/or a breast density grade of 4, should discuss with their physician the benefits of having an MRI performed in conjunction with mammography.

How did I develop dense breasts?
Genetic research in the past decade has revealed that dense breast tissue can be hereditary. How your breasts feel does not always correlate with how dense the tissue appears on imaging, so you may not know you have this inherited trait until you get a mammogram.

How do I know if I have dense breasts?
You have dense breasts if your mammogram shows a breast density grade of 3-4. The Covenant Breast Health Center includes your breast density in your mammogram report, which is sent to your primary physician. Ask your physician what your breast density is and discuss which screening exams are best for you.

Do I have less chance of survival if I have dense breasts and develop breast cancer?
Early detection is still the best protection. A National Cancer Institute study tracked more than 9,000 breast cancer patients and concluded those with very dense breasts were just as likely to survive as patients whose breasts were not dense.

Will my insurance cover additional screening exams for dense breasts?
At this time, there is no guarantee that your insurance company will cover an Automated Whole Breast Ultrasound, 3D Tomosynthesis or MRI for your breasts. We recommend you contact your insurance company to find out if you are covered under your specific program.

What can I do to decrease my risk of developing breast cancer?

  • Ask your doctor what your breast density grade is and discuss which screening exams are right for you, especially if you have dense breasts.
  • Know your risks:
    • Know your family health history.

Determine your lifetime risk for breast cancer. One of the ways you can do this is by calculating your Gail Score here.

  • Get screened:
    • If you are at average risk, get a mammogram done every year starting at age 40.
    • Have a clinical breast exam done at least every three years starting at age 20 – every year once you reach age 40.
  • Know what is normal for you and see your doctors if you notice any of these breast changes:
    • Lump, hard knot or thickening inside the breast or underarm area.
    • Swelling, warmth, redness or darkening of the breast.
    • Change in the size or shape of the breast.
    • Dimpling or puckering of the breast skin.
    • Itchy, scaly sore or rash on the nipple.
    • Pulling in of your nipple or other parts of your breast.
    • Nipple discharge that starts suddenly.
    • New pain in one spot that does not go away.
  • Make health lifestyle choices:
    • Maintain a healthy weight.
    • Exercise on a regular basis.
    • Limit your alcohol intake.
    • Limit postmenopausal hormone use.
    • Breastfeed if you have a baby.
  • Educate yourself by visiting: