الفهرس 
AIM OF WORKOnly 14 pages are availabe for public view
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Abstract
Different Breast lesions and specially breast cancer which remains one of the leading causes of death in women over the age of 40 years leading to numerous women health problems. (Yang et al 2013).
Breast imaging is currently undergoing a major change with the wide spread implementation of Full Field Digital Mammography equipment, ABUS and tomosynthesis. (Sieeba, et al, 2013).
Mammographic breast density is a well-established and strong predictor of breast cancer risk. Women with extensive breast density are at higher risk of developing breast cancer (Sieeba, et al, 2013).
The study revealed that detection of the breast lesions and specially breast cancer by merging the mammogram and ABUS together shows significant increased in comparison to mammogram only specially in dense breast women and women with contraindication to mammogram. (Jamal et al, 2010).
Breast lesions including breast cancer rates are increasing in developing countries, including Egypt, and are largely attributed to aging of the population, delay in time of first pregnancy, decrease in number of children and in breastfeeding. . (Jamal et al, 2010).
Breast lesions screening is used to identify women with asymptomatic and mildly symptomatic lesions with the goal of enabling women to undergo less treatments that lead to better outcomes, ideally at earlier stages and before the disease progresses specially breast cancer. There are important considerations for who should be screened, how often women should be screened, and with which imaging modality (or modalities). (Mackenzie et al, 2015).
Mammography is the best-studied breast screening modality and the only recommended imaging tool for screening the general population of women. Deciding when and how to participate in screening should involve a personalized session between a woman and her provider, weighing the individual breast her risk factors and competing co-morbidities. In addition, a balanced session regarding both the benefits and risks of routine screening is warranted (Mackenzie et al, 2015).
Mammographic breast density is a well-established and strong predictor of breast cancer risk. Women with extensive breast density are at higher risk of developing breast cancer
Mammography is also often examined with HHUS, a technique that since long has been used as an adjunctive diagnostic tool because it is not hampered by the limitation of breast density. However, HHUS is operator dependent, time-consuming and difficult to reproduce. Although in the very recently published ACRIN study, (Berg et al.) found the cancer detection rate by HHUs to be similar to FFDM with more calcified DCIS detected by FFDM and more likely invasive node negative cancer detected by HHUS. Nonetheless, HHUS still has the drawback of yielding more false positive findings. Therefore, automated three-dimensional (3D) ultrasound was developed.
The goals of automated breast ultrasound are:
• Decrease the radiologist’s time per case.
• Produce a standardized, high quality examination that improves the conspicuity of cancers
(I J. Humphreys, 2013).
In contrast to HHUS, 3D automated breast ultrasound system (ABUS) has a standardized acquisition protocol that can be performed by medical personnel after short training without the need for highly trained radiologists during the examination. 3D ABUS acquires large 3D volumes that overlap and can be evaluated multiplanar: coronal, transverse and sagittal. Contrary to standard HHUS, 3D ultrasound technology can visualize each sectional plane of the saved volume because of its digital character. This practice enables temporal comparison which is a key factor in breast cancer screening. Breast cancer often appears as a stellate lesion with desmoplastic reaction disrupting the normal parallel soft tissue plane by producing a contraction of breast tissue towards the mass. The finding can be seen on several slices which make the perception easier (I J. Humphreys, 2013).
Because of its capabilities, 3D ABUS enables reproducibility and can in essence eliminate the investigator-dependent and non-standardized documentation. These are characteristics that could make 3D ABUS a very useful addition to the diagnostic breast screening. (Brem et al, 2014).
Automated breast Ultrasound scanners were initially planned to effectively examine the breast in its entirety. Nowadays ABUS systems can automatically scan the entire breast in a standard manner with optimized settings (imaging presets) for volume acquisition based on the estimated size of the breast (A is smallest size; D+ is largest size), the system applies imaging parameters during acquisition based on the estimated size of the breast and automatically send all the images to an ABUS workstation. (Wang H.et al. 2012)