A breast ultrasound is a study of your breast done using ultrasound waves. Ultrasound is considered a complement to mammography — not a replacement.
In women age 30 or older who are experiencing signs or symptoms possibly related to breast cancer, our starting point is a mammogram. A breast ultrasound may be done if needed to evaluate findings in the physical examination or the mammogram. In women who have a lump and are under the age of 30 or are pregnant or lactating, ultrasound is used as the starting point. If the ultrasound is normal, nothing more is usually done. However, if a breast cancer is suspected on the ultrasound, a full mammogram is done.
Ultrasound is useful in evaluating the axilla, or armpit, for potentially abnormal lymph nodes, particularly in patients with breast cancer. Breast ultrasound is also used to guide the radiologist during biopsies and fine needle aspirations.
About the Procedure
This study is operator-dependent, requiring optimal equipment and meticulous technique to ensure accurate results. For these reasons, all breast ultrasound studies at our facilities are done by one of our breast imaging radiologists.
During a breast ultrasound study, you usually lie on your back or slightly turned to one side with your arm placed comfortably under your head. Gel is applied to your breast so there are no air pockets between your skin and the transducer — the instrument used to obtain the pictures. The transducer is moved back and forth over your breast, generating images and, if an abnormality is found, images are taken for your medical record.
A physical examination of your breast is also done by the radiologist at the time of the ultrasound. Combining the ultrasound with physical findings is the equivalent of being able “to see” with our fingertips.
Ultrasound is used to characterize lumps detected on a mammogram or physical examination as:
- Fluid-filled = cysts (benign, not cancerous)
- Not fluid-filled, but likely benign
- Not fluid-filled and indeterminate
- Not fluid-filled and likely cancerous
- Areas of fatty tissue, or lobulation
Lumps identified as cysts (fluid-filled) do not require any intervention or follow-up, unless you are having symptoms or atypical features are seen on ultrasound, in which case aspiration can be done.
If the lump is unequivocally benign, no follow-up may be needed. With solid, non-fluid-filled lumps, if the likelihood of malignancy is determined to be less than 2 percent based on clinical and imaging features, a six month follow-up is usually recommended. A biopsy is indicated for those that are characterized as indeterminate or likely cancerous.