What is Breast Ultrasound?
Breast ultrasound is an imaging test in the radiology field that uses sound waves to generate images of the breasts without any radiation. This type of ultrasound is normally used in conjunction with mammography to help diagnose or clarify a tumor or mass that was revealed. Common reasons for a breast ultrasound include detecting palpable lumps, evaluating pregnant or lactating women, or examining patients with dense breast tissue. If patients are at risk for breast cancer, their doctor may order a breast ultrasound along with their screening mammogram.
How to prepare for a breast ultrasound
Once patients arrive for their breast ultrasound appointment, they must remove any deodorant or lotion that is under their arms (axillary area), on their breasts, or around their breasts. Even though you may be imaging the breast tissue, if there is a concern seen on the breast ultrasound, the technologist or radiologist will scan their axillary regions where their lymph nodes are located. If a patient has a tumor that raises a concern for malignancy, the lymph node area will be the first area where the cancer will metastasize.
The Breast Ultrasound Procedure
Depending on if you are having one breast scanned or both, the ultrasound can take anywhere from 15 minutes to 30 minutes to perform. The patient will lie in a supine position first (on their back), and then a cushion or sponge will be placed behind the patient’s back to place them in a supine oblique position. The angle of the patient will be determined by the thickness of their breast tissue and the area of concern. A warm gel is applied to the ultrasound probe or the patient’s breast to allow sound waves to travel properly, generating detailed and uniform images without artifacts.
Is breast ultrasound ordered for breast pain?
A breast ultrasound is not routinely ordered for patients that present with breast pain. If patients are above age 35 and are not pregnant, a mammogram will be performed first to determine why the patient is having breast pain If the mammogram was normal or negative for cancer or suspicious tumors within the past year, the radiologist might recommend starting with a breast ultrasound.
Breast ultrasound for breast cysts
A breast ultrasound may be ordered if the mammogram report was abnormal. The patient’s report will state to follow up for diagnostic mammogram images. During this appointment, the mammography and/or ultrasound technologist must read the radiologist’s report to determine if you should start with mammogram images first or breast ultrasound images.
When scanning the breast under ultrasound, it is important to annotate the machine correctly to the breast that is being imaged. For example, Right breast, transverse/sagittal, 12:00, 6cmfn (centimeters from nipple). Annotating the images correctly is critical to ensure that you are imaging the correct area of the breast.
What are breast cysts?
A breast cyst is a noncancerous (benign), fluid filled sac within the breasts. It usually occurs when fluid fills an empty milk duct. Breast cysts may become painful before the start of your menstrual cycle. Breast cysts may occur if you are between 35 and 50 years old. Most patients do not know they have breast cysts. It may be found on their initial mammogram before they know that there are cysts within their breasts.
Breast cysts are common and are categorized as simple, complicated, and complex. For the simple breast cyst, a follow up appointment is usually not recommended and their provider and radiologist will keep watching the cyst each year once the patient has their annual mammograms. For complicated and complex breast cysts, an ultrasound guided breast biopsy is recommended to determine if the cyst is benign or malignant for breast cancer.
How is breast ultrasound used for breast cysts?
Breast ultrasound can be used to determine if the breast cyst is benign or malignant through an ultrasound guided biopsy procedure. Cyst aspirations are performed under ultrasound guidance as well. If a cyst is small, the radiologist usually does not recommend a cyst aspiration if there are no symptoms present. If the breast cyst is large and painful, the radiologist will recommend a cyst aspiration to relieve the pain and promote comfortability for the patient.
What to expect after the breast ultrasound?
After the ultrasound, the radiologist may provide preliminary results before sending an official report to the doctor, which usually takes 1-3 days. Depending on the results, the radiologist may recommend a follow-up examination, biopsy, or aspiration. If the results are normal or negative for malignancy, the patient will be advised to return for their annual mammogram or breast ultrasound as appropriate. After the examination, patients can wipe off the ultrasound gel and ask any questions.
References
Malherbe, Kathryn. “Breast Ultrasound.” Stat Pearls [Internet]., U.S. National Library of Medicine, 10 Jan. 2024, www.ncbi.nlm.nih.gov/books/NBK557837/.
Professional, Cleveland Clinic medical. “What Are Breast Cysts.” Cleveland Clinic, my.clevelandclinic.org/health/diseases/15691-breast-cysts. Accessed 7 July 2024.
Professional, Cleveland Clinic Medical. “What’s A Breast Ultrasound & Why Do I Need One?” Cleveland Clinic, my.clevelandclinic.org/health/diagnostics/21496-breast-ultrasound. Accessed 6 July 2024.
