Breast ultrasound

Breast ultrasound is a non-invasive diagnostic imaging technique used to visualize the internal structures of the breast. It employs high-frequency sound waves to produce detailed images of the breast tissue, aiding in the detection and characterization of breast abnormalities, including cysts, fibroadenomas, and cancerous tumors. Unlike mammography, which uses X-rays, breast ultrasound does not involve exposure to ionizing radiation, making it a safer option for certain populations, such as pregnant women and those with dense breast tissue.

Indications

Breast ultrasound is commonly used for several purposes:

• To further evaluate abnormalities detected by mammography or during a physical examination.
• To distinguish between solid tumors and fluid-filled cysts.
• To guide biopsies of suspicious breast lesions.
• As a supplementary screening tool for women with dense breast tissue, where mammography may be less effective.
• In pregnant or lactating women, where other forms of breast imaging may pose risks.

Procedure

During a breast ultrasound, the patient lies on their back or slightly turned on an examination table. A small amount of water-based gel is applied to the area of interest to facilitate the transmission of sound waves. A handheld device called a transducer is then moved over the skin surface of the breast. The transducer emits sound waves that penetrate the breast tissue and bounce back to the device, creating echoes that are converted into digital images displayed on a monitor.

Benefits and Limitations

Benefits:

• No exposure to ionizing radiation.
• Can effectively image dense breast tissue.
• Non-invasive and relatively quick procedure.
• Useful for guiding needle biopsies.

Limitations:

• May not detect some early signs of cancer, such as microcalcifications, as effectively as mammography.
• Operator-dependent technique that can vary in accuracy.
• Not a replacement for mammography in general breast cancer screening.

Interpretation

The images produced by breast ultrasound are interpreted by a radiologist. Findings are typically categorized according to the BI-RADS (Breast Imaging-Reporting and Data System) scale, which ranges from 0 (incomplete) to 6 (known biopsy-proven malignancy), guiding the next steps in patient management.

Risks

Breast ultrasound is considered a safe procedure with minimal risks. The primary concern is the potential for false-positive or false-negative results, which could lead to unnecessary anxiety, further testing, or delayed diagnosis.

Conclusion

Breast ultrasound is a valuable diagnostic tool in the evaluation of breast abnormalities, particularly as a complement to mammography. Its safety profile and effectiveness in certain patient populations make it an important component of comprehensive breast care.