###### Abstract
in [21], with respect to the prediction of breast cancer size on histology, confirm the superiority of MRI. However, ABVS was slightly more accurate than MRI in the subgroup of lesions of \(\leq\)2 cm. In contrast, ABVS showed better histological agreement than HHUS, especially for intraductal tumors and lesions of \(>\)2 cm. Both of the techniques showed significant or near perfect agreement in evaluating the sonographic characteristics of breast lesions. The study [21] concluded that ABVS was better than HHUS, and similar to MRI, in assessing the size of breast cancer. In the paper [22], [PERSON] et al. compared the concordance of ABVS with HHUS using the Kappa statistic, which is frequently used to estimate inter-rater reliability [23]. [PERSON]'s Kappa value was \(\kappa=0.37\), indicating good agreement. In conclusion, they stated that ABVS should still be considered as an experimental technique of breast ultrasound, which definitely needs further evaluation studies. However, the literature also shows results that confirm that ABUS was more accurate than HHUS in assessing the extent of the disease and the average size of the lesion [24], the larger diameter [25], and the total volume [26] are important in the preoperative field to assess the real extension of the lesion. Compared to HHUS, ABUS allows the better detection of architectural distortions and hyperechoic rims in the coronal plane [27; 28]. The complete data acquired from the entire breast volume enable the better determination of the 3D location of a lesion with less inter-observer variability. This allows for more reproducible and less operator-dependent examination in an optimized reading environment [27; 28; 29; 30; 31]. Furthermore, digital data enable computer-aided detection (CAD) and quantitative texture analysis of breast lesions [32]. Another interesting application is the possibility of correlating the imaging features obtained with ABUS with the molecular subtypes of breast cancer. [PERSON] et al. [33], in a study of malignant breast tumors, showed a strong correlation between the \"retraction phenomenon\" and molecular subtypes. Therefore, compared to HHUS, ABUS is a valuable additional tool, not only in screening, but also in the clinical field, in the characterization and diagnostic accuracy of breast lesions. In general, it can be concluded that ABUS offers a valuable impact on the detection and differentiation of malignant from benign breast lesions, with higher inter-observer agreement. The use of this technique, both in screening, as an adjunct to MMG, and in clinical practice, appears to offer excellent results, not worse than the traditional HHUS examination, with the benefit of great savings in physician time and a reduction in some of the most common problems associated with HHUS [34]. ABUS and digital tomosynthesis are currently thought to be the most promising candidates to supplement population-based breast cancer screening in women with heterogeneous and extremely dense breasts who do not meet the high-risk criteria for MRI screening [9]. The presumed incremental cancer detection rates of approximately 2 per 1000, in addition to mammography, for both modalities are in the same range. However, ABUS is a tomographic method that does not have the adverse effects of ionizing radiation and detects a spectrum of invasive cancers different from that of tomosynthesis. Moreover, due to its characteristics, ABUS is particularly promising for research using artificial intelligence and radiomics, opening up new and fascinating research scenarios in the diagnostic field [15]. However, there are also some major limitations of ABUS, such as the exclusion of the axillary region from the field of view and the lack of tools to assess vascularity and tissue elasticity [35]. In view of the above analysis regarding ABUS systems, their specialized application, and their significant purchase costs, they are not very popular.