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Abstract：
BACKGROUND: Although DBT is the standard initial imaging modality for women with focal breast symptoms, the importance of ultrasound has grown rapidly in the past decades. Therefore, the Breast UltraSound Trial (BUST) focused on assessing the diagnostic value of ultrasound and digital breast tomosynthesis (DBT) for the evaluation of breast symptoms by reversing the order of breast imaging; first performing ultrasound followed by DBT. This side-study of the BUST evaluates patients\' perceptions of ultrasound and DBT in a reversed setting.
METHODS: After imaging, 1181/1276 BUST participants completed a survey consisting of open and closed questions regarding both exams (mean age 47.2, ±11.74). Additionally, a different subset of BUST participants (n = 29) participated in six focus group interviews 18-24 months after imaging to analyze their imaging experiences in depth.
RESULTS: A total of 55.3% of women reported reluctance to undergoing DBT, primarily due of pain, while the vast majority also find bilateral DBT reassuring (87.3%). Thematic analysis identified themes related to 1) imaging reluctance (pain/burden, result, and breast harm) and 2) ultrasound and DBT perceptions. Regarding the latter, the theme comfort underscores DBT as burdensome and painful, while ultrasound is largely perceived as non-burdensome. Ultrasound is also particularly valued for its interactive nature, as highlighted in the theme interaction. Perceived effectiveness reflects women\'s interest in bilateral breast evaluation with DBT and the visibility of lesions, while they express more uncertainty about the reliability of ultrasound. Emotional impact portrays DBT as reassuring for many women, whereas opinions on the reassurance provided by ultrasound are more diverse. Additional themes include costs, protocols and privacy.
CONCLUSIONS: Ultrasound is highly tolerated, and particularly valued is the interaction with the radiologist. Nearly half of women express reluctance towards DBT; nevertheless, a large portion report feeling more confident after undergoing bilateral DBT, reassuring them of the absence of abnormalities. Understanding patients\' perceptions of breast imaging examinations is of great value when optimizing diagnostic pathways.
METHODS: After imaging, 1181/1276 BUST participants completed a survey consisting of open and closed questions regarding both exams (mean age 47.2, ±11.74). Additionally, a different subset of BUST participants (n = 29) participated in six focus group interviews 18-24 months after imaging to analyze their imaging experiences in depth.
RESULTS: A total of 55.3% of women reported reluctance to undergoing DBT, primarily due of pain, while the vast majority also find bilateral DBT reassuring (87.3%). Thematic analysis identified themes related to 1) imaging reluctance (pain/burden, result, and breast harm) and 2) ultrasound and DBT perceptions. Regarding the latter, the theme comfort underscores DBT as burdensome and painful, while ultrasound is largely perceived as non-burdensome. Ultrasound is also particularly valued for its interactive nature, as highlighted in the theme interaction. Perceived effectiveness reflects women\'s interest in bilateral breast evaluation with DBT and the visibility of lesions, while they express more uncertainty about the reliability of ultrasound. Emotional impact portrays DBT as reassuring for many women, whereas opinions on the reassurance provided by ultrasound are more diverse. Additional themes include costs, protocols and privacy.
CONCLUSIONS: Ultrasound is highly tolerated, and particularly valued is the interaction with the radiologist. Nearly half of women express reluctance towards DBT; nevertheless, a large portion report feeling more confident after undergoing bilateral DBT, reassuring them of the absence of abnormalities. Understanding patients\' perceptions of breast imaging examinations is of great value when optimizing diagnostic pathways.
摘要：
背景：尽管DBT是有局灶性乳腺症状的女性的标准初始成像模式，在过去的几十年中，超声波的重要性迅速增长。因此,乳腺超声试验(BUST)通过颠倒乳腺成像的顺序,重点评估超声和数字乳腺断层合成(DBT)对乳腺症状的诊断价值;首先进行超声检查,然后进行DBT检查.BUST的这项侧面研究评估了患者在相反设置下对超声和DBT的看法。
方法：成像后，1181/1276BUST参与者完成了一项调查，其中包括有关两项考试的开放式和封闭式问题（平均年龄47.2，±11.74）。此外,不同子集的BUST参与者(n=29)在成像后18~24个月参加了6次焦点小组访谈,以深入分析他们的成像经验.
结果：共有55.3%的女性表示不愿意接受DBT，主要是因为疼痛,而绝大多数人也认为双边DBT令人放心(87.3%)。主题分析确定了与1相关的主题)成像不情愿(疼痛/负担，结果,和乳房伤害)和2)超声和DBT感知。关于后者,主题舒适强调DBT是繁重和痛苦的，而超声在很大程度上被认为是无负担的。超声也因其交互性而特别受到重视，正如主题互动中所强调的那样。感知有效性反映了女性对DBT双侧乳腺评估的兴趣和病变的可见性，而他们对超声波的可靠性表达了更多的不确定性。情感影响将DBT描绘成让许多女性放心，而关于超声提供的安慰的意见则更加多样化。其他主题包括费用，协议和隐私。
结论：超声具有很高的耐受性，尤其值得重视的是与放射科医生的互动。近一半的女性对DBT表示不情愿；然而，很大一部分报告在接受双边DBT后感觉更有信心，让他们放心，没有异常。在优化诊断途径时，了解患者对乳腺影像学检查的看法具有重要价值。
方法：成像后，1181/1276BUST参与者完成了一项调查，其中包括有关两项考试的开放式和封闭式问题（平均年龄47.2，±11.74）。此外,不同子集的BUST参与者(n=29)在成像后18~24个月参加了6次焦点小组访谈,以深入分析他们的成像经验.
结果：共有55.3%的女性表示不愿意接受DBT，主要是因为疼痛,而绝大多数人也认为双边DBT令人放心(87.3%)。主题分析确定了与1相关的主题)成像不情愿(疼痛/负担，结果,和乳房伤害)和2)超声和DBT感知。关于后者,主题舒适强调DBT是繁重和痛苦的，而超声在很大程度上被认为是无负担的。超声也因其交互性而特别受到重视，正如主题互动中所强调的那样。感知有效性反映了女性对DBT双侧乳腺评估的兴趣和病变的可见性，而他们对超声波的可靠性表达了更多的不确定性。情感影响将DBT描绘成让许多女性放心，而关于超声提供的安慰的意见则更加多样化。其他主题包括费用，协议和隐私。
结论：超声具有很高的耐受性，尤其值得重视的是与放射科医生的互动。近一半的女性对DBT表示不情愿；然而，很大一部分报告在接受双边DBT后感觉更有信心，让他们放心，没有异常。在优化诊断途径时，了解患者对乳腺影像学检查的看法具有重要价值。
