Ultrasound imaging of the breast uses sound waves to produce pictures of the internal structures of the breast. It is primarily used to help diagnose breast lumps or other abnormalities your doctor may have found during a physical exam, mammogram or breast MRI. Ultrasound is safe, noninvasive and does not use radiation. Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions.

Doppler ultrasound is a special ultrasound technique that evaluates movement of materials in the body. It allows the doctor to see and evaluate blood flow through arteries and veins in the body. Ultrasound imaging of the breast produces a picture of the internal structures of the breast. This procedure requires little to no special preparation. Leave jewelry at home and wear loose, comfortable clothing. You will be asked to undress from the waist up and to wear a gown during the procedure.

Keywords: Breast Ultrasound, Ultrasound imaging, Imaging of Breasts

What are some common uses of the procedure?

• Determining the Nature of a Breast Abnormality
  The primary use of breast ultrasound is to help diagnose breast abnormalities detected by a physician during a physical exam (such as a lump) and to characterize potential abnormalities seen on mammography or breast magnetic resonance imaging (MRI).
  
  Ultrasound imaging can help to determine if an abnormality is solid (which may be a non-cancerous lump of tissue or a cancerous tumor), fluid-filled (such as a benign cyst) or both cystic and solid.
  
  Doppler ultrasound is used to assess blood supply in breast lesions.

• Supplemental Breast Cancer Screening
  Mammography is the only screening tool for breast cancer that is known to reduce deaths due to breast cancer through early detection. Even so, mammograms do not detect all breast cancers. Some breast lesions and abnormalities are not visible or are difficult to interpret on mammograms. Breasts that are considered dense have a lot of glandular and connective tissues and not much fatty tissue, and that makes cancer harder to detect.
  
  Many studies have shown that ultrasound and magnetic resonance imaging (MRI) can help supplement mammography by detecting breast cancers that may not be visible with mammography. Your doctor can help you determine if either of these tests is appropriate for you. MRI is more sensitive than ultrasound in depicting breast cancer, but MRI may not be available to all women. If screening MRI is performed, then screening ultrasound is not needed, though ultrasound may be used to characterize and biopsy abnormalities seen on MRI. When ultrasound is used for screening, abnormalities not visible with mammography may be identified, including some that may require biopsy. Many of the abnormalities found with screening breast ultrasound are not cancer (false positives).
•  Ultrasound can be offered as a screening tool for women who:

• Are at high risk for breast cancer and unable to undergo an MRI examination.
• Are pregnant or should not be exposed to x-rays (which are necessary for a mammogram).
• Have increased breast density — when the breasts have a lot of glandular and connective tissue and not much fatty tissue (see the Dense Breasts page for more information).
• Ultrasound-guided Breast Biopsy
  when an ultrasound examination reveals a suspicious breast abnormality, a physician may choose to perform an ultrasound-guided biopsy. Because ultrasound provides real-time images, it is often used to guide biopsy procedures. An ultrasound exam will usually need to be performed before the biopsy in order to plan the procedure and to determine if this method of biopsy can be used.

How should I prepare?

You will be asked to undress from the waist up and to wear a gown during the examination.

How is the procedure performed?

You will lie on your back on the examining table and may be asked to raise your arm above your head.

After you are positioned on the examination table, the radiologist (a physician specifically trained to supervise and interpret radiology examinations) or sonographer will apply a warm water-based gel to the area of the body being studied. The gel will help the transducer make secure contact with the body and eliminate air pockets between the transducer and the skin that can block the sound waves from passing into your body. The transducer is placed on the body and moved back and forth over the area of interest until the desired images are captured.

There is usually no discomfort from pressure as the transducer is pressed against the area being examined. However, if scanning is performed over an area of tenderness, you may feel pressure or minor pain from the transducer.

Doppler sonography is performed using the same transducer.

Once the imaging is complete, the clear ultrasound gel will be wiped off your skin. Any portions that are not wiped off will dry quickly. The ultrasound gel does not usually stain or discolor clothing.

What will I experience during and after the procedure?

• Most ultrasound exams are painless, fast and easily tolerated.
• Breast ultrasound is usually completed within 30 minutes.
• If a Doppler ultrasound study is performed, you may actually hear pulse-like sounds that change in pitch as the blood flow is monitored and measured.
• You may be asked to change positions during the exam.
• When the exam is complete, you may be asked to dress and wait while the ultrasound images are reviewed.
• After an ultrasound examination, you should be able to resume your normal activities immediately.

What are the benefits vs. risks?

Benefits

• Most ultrasound scanning is noninvasive (no needles or injections).
• Occasionally, an ultrasound exam may be temporarily uncomfortable, but it should not be painful.
• Ultrasound is widely available, easy-to-use and less expensive than most other imaging methods.
• Ultrasound imaging is extremely safe and does not use radiation.
• Ultrasound scanning gives a clear picture of soft tissues that do not show up well on x-ray images.
• Ultrasound provides real-time imaging, making it a good tool for guiding minimally invasive procedures such as needle biopsies and fluid aspiration.
• Ultrasound imaging can help detect lesions in women with dense breasts.
• Ultrasound may help detect and classify a breast lesion that cannot be interpreted adequately through mammography alone.

Risks

• Standard diagnostic ultrasound has no known harmful effects on humans.
• Interpretation of a breast ultrasound examination may lead to additional procedures such as follow-up ultrasound and/or aspiration or biopsy. Many of the areas thought to be of concern turn out to be non-cancerous (false positives).