Abstract
Recently, the role of breast ultrasound has become more important. In this situation, the importance of education and the establishment of guidelines for breast ultrasound has been highlighted. The present paper addresses some of the problems associated with the current Japan Association of Breast and Thyroid Sonology (JABTS) guidelines for breast ultrasound, and discusses the future of the guidelines. For example, the JABTS breast ultrasound guidelines were formulated on the basis of expert opinions, so in the future, they will need to be modified based on evidence. Furthermore, it will be important to establish new evidence-based diagnostic criteria. For this purpose, multicenter studies will need to address themes such as color Doppler and elastography, and it will be necessary to disclose the process of making new diagnostic criteria in order to increase reliability. It will also be important to consider approaches that have been adopted in countries outside Japan, as the JABTS guidelines only apply domestically, whereas other countries use BI-RADS ultrasound. Many of the criteria of the JABTS guidelines are the same as those of BI-RADS ultrasound, but others differ. Therefore, establishing consistency with BI-RADS ultrasound must be considered. There are also various other pertinent issues such as the definition of internal echoes, criteria for complicated cysts, and so on. These problems will need to be solved, and attempts to formulate better guidelines will be necessary in future.
