JCO Global Oncology · Oct 28, 2026

Use of Portable Ultrasound by Nonradiologists to Triage Women With Abnormal Clinical Breast Examination Findings: A Prospective Study in India

By Pai DK, Sarkar DK, Gangadharan H et al.

PURPOSE: Clinical breast examination (CBE) is widely used for breast cancer screening and evaluation of symptomatic women in low- and middle-income countries (LMICs). However, its limited specificity leads to high false-positive rates and unnecessary referrals. We evaluated a point-of-care triage strategy using portable ultrasound devices (PUDs), performed by nonradiologist clinicians, to improve the positive predictive value (PPV) of CBE and reduce referrals. METHODS: Women age 40-75 years with abnormal CBE findings were recruited from two settings: asymptomatic women identified through community-based screening and symptomatic women presenting to breast clinics. Trained nonradiologist clinicians used PUDs to classify findings as triage-negative (no abnormality/benign) or triage-positive (suspicious). All participants underwent standard diagnostic evaluation irrespective of PUD findings. RESULTS: A total of 319 women were enrolled (149 screening; 170 diagnostic). PUD triage was positive in 44.3% of women in the screening group and 72.4% in the diagnostic group. Breast cancer was diagnosed in 37 (24.8%) women in the screening group and 121 (71.2%) in the diagnostic group. PUD triage identified all cancers in the screening setting and all but nine in the diagnostic setting, yielding an overall sensitivity of 94.3% and specificity of 76.7%. Use of PUD substantially improved PPV and reduced referrals by approximately 50%. CONCLUSION: Point-of-care ultrasound performed by trained nonradiologist clinicians can effectively triage women with abnormal CBE findings, improving PPV and reducing unnecessary referrals. This approach may enhance efficiency of breast cancer early detection programs in LMICs. Further studies are warranted to assess performance in routine program settings.

doi.org/10.1200/go-26-00354Open accessPubMed 42950178Biomarkers