To assess the diagnostic value of automated breast volume scanning (ABVS) in comparing and observing the peripheral signs of breast tumors on three orthogonal sections.

A retrospective analysis was performed on 206 women with 292 breast tumors who underwent breast surgery and postoperative pathological diagnosis at Shanxi Provincial Cancer Hospital from April 2017 to May 2019. ABVS was performed in all patients before operation to compare the diagnostic efficacy of ABVS on three different orthogonal sections for breast benign and malignant tumors, and to analyze the overall diagnostic efficacy of ABVS on three orthogonal sections for breast benign and malignant tumors.

Of the 292 lesions, 148 were benign and 144 were malignant. Using the postoperative pathological results as the "gold standard", the sensitivity of coronal burr sign (68.05%) was significantly higher than that of transverse (17.36%) and sagittal (13.19%) sign (P<0.05). The sensitivity of coronal edge angulation (42.36%) was also significantly higher than that of transverse (26.38%) and sagittal (22.22%) edge angulation (P<0.001).There was no significant difference in the sensitivity of lobular and marginal fuzzy signs for the diagnosis of breast cancer (P>0.05). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of edge microlobulation, burr, edge angulation, and edge blur on ABVS were 81.94%, 86.48%, 85.50%, 83.11%, and 84.24%), 68.75%, 96.62%, 95.19%, 76.06%, and 82.87%, 47.22%, 95.27%, 91.89%, 64.97%, and 71.57%, and 54.16%, 57.43%, 55.31%, 56.29%, and 55.82%, respectively.

Coronal burr sign and marginal angulation on ABVS are superior to those on sagittal and transverse sections in the evaluation of benign and malignant breast tumors with regard to diagnostic sensitivity. Compared with other peripheral features, micro-lobulation is the most sensitive and accurate surface feature for the diagnosis of malignant nodules.