A breast ultrasound or breast sonography is a noninvasive, harmless, and painless procedure that makes the use of high-frequency sound waves to produce images of the breast tissue. The sound waves are not audible to the human ear.

They pass through the breast tissue bouncing off them and differentiating normal tissue from the abnormal one. It is an important diagnostic procedure in breast cancer to rule out malignancy from any abnormality.

These sound waves are interpreted by a computer and translated into radiological images or videos. This diagnostic procedure is also known as ultrasound imaging or ultrasound scanning or sonography.

This test is often done when a mammogram shows some changes in the breast tissue or when you feel a change in the breast consistency, which does not show on a mammogram.

Uses

Breast ultrasound is used to tell whether the breast mass is a solid lump or a cyst filled with fluid.

Further, it can also differentiate between a benign lump and a malignant one. However, breast ultrasound is not routinely done to screen for breast cancer because it may miss some of its early signs such as tiny calcium deposits called microcalcifications.

If a lump has been detected, its precise location,  as seen on the ultrasound, helps guide the needle during a breast biopsy for taking the tumor material for a histopathology examination.

Breast ultrasound can show the movements of the organ and also the blood flowing through the blood vessels.

It is safe to use during pregnancy because there is no radiation involved. It is also safe to use in people who are allergic to contrast dye because this procedure does not use a dye.

A breast ultrasound helps to differentiate between a fluid-filled cyst and a solid tumor.

Breast ultrasound procedure

You should not schedule your breast ultrasound one week before your menstrual period, as your breasts are usually very sensitive at this time.

According to a new study, the best time to have the breast ultrasound done is during the first week of their menstrual cycle. The breast tissue is usually less dense during this week, so the ultrasounds conducted at this time may be more accurate.

You should carry with you any previous mammogram films with you so that the radiologist can use them to compare with your current result. You should leave all your jewelry at home.

  • You are asked to lie down on the back with the upper half of your body totally bare.
  • The technician applies a water-soluble gel is applied over the breast.
  • He presses a soft microphone-like device called the transducer firmly over the skin of the breast and gently moves it over the breast.
  • You may be asked to hold your breath a few times.
  • The procedure is harmless, painless, fast, and easy. It is completed within ten to twenty minutes.
  • Once the procedure is over, you are asked to wipe the gel with a tissue.

Results are immediately available as the radiologist is viewing the computer screen during the procedure and interpreting the results.

Indications

The doctor will advise a breast ultrasound:

  • If you have dense breasts that may contraindicate a mammogram
  • If you are pregnant
  • If you are 25 years old or younger
  • To diagnose an abnormality seen on a mammogram
  • To see if breast implants have broken open (ruptured)
  • To tell whether the breast lump is a cyst or a solid growth that may be malignant.
  • To accurately pinpoint the position of a tumor. This is helpful during a breast biopsy to guide the doctor to place the biopsy needle correctly.

Uses and limitations of breast ultrasound

Breast ultrasound can detect small breast tumors that have been missed in mammography. MRI is more sensitive than ultrasound but not all women can tolerate contrast-enhanced MRI.

In such women, ultrasound serves as an alternative. Many a time, tumors diagnosed as breast cancer on ultrasound turn out to be non-malignant (false positive) on breast biopsy. This limits its cost-effectiveness.

When an ultrasound detects breast cancer, a biopsy is required for further confirmation. Ultrasound is also used by the doctor to help him guide the biopsy needle accurately into the suspicious part of the breast. As ultrasound produces instant imaging, it becomes very useful to guide biopsy procedures.