Breast Ultrasound


Ultrasound is a diagnostic imaging tool that has been in use for many years. Compared to other types of imaging techniques, such as mammography and MRI, the technology is more portable, requiring only a handheld transducer and software, and is relatively less expensive. However, there are limitations to using traditional hand-held ultrasound that have prevented the technology from being used as a screening tool. The length of traditional ultrasound tests is one setback, as it can take up to 30 minutes to complete the exam. Another issue that ultrasound screening presents is operator dependency. The results obtained in an ultrasound exam are highly dependent on the skill and expertise of the operator.  Breast density is now a known risk cancer to the development of breast cancer, which invigorated the search for supplemental screening strategies and the development of automated breast ultrasound technology.

Ultrasound of cancer

Breast ultrasound is a complimentary tool, used to evaluate findings on mammogram, MRI, and other breast imaging modality.  In addition, if a mass or lump is felt in the breast, an ultrasound is an excellent tool, used, to determine whether or not the mass is cystic (fluid filled) or solid.  There is no radiation with breast ultrasound, which is certainly an advantage, however, to date, ultrasound is not typically used as a screening tool.  Mammography remains the ‘gold standard’ in this regard.

GE-Logiq-7-UltrasoundUltrasound is an excellent tool used to determine whether a lesion is a cyst or solid.  The distinction is important, as most cysts are benign (not cancer) and solid lesions may need biopsy; as most cancers are solid.

Ultrasound is a versatile modality because it is portable, and, does not emit radiation and is painless.  Ultrasound of the breast can typically be performed in the office of a physician, or in the Breast Imaging Department of a hospital.




    • a suspicious mass by ultrasound is irregular and solid.  Because cancers are generally ‘hard’, the sound waves from an ultrasound do not traverse the lesion easily.  This lack of transmission produces a shadowing beneath the mass/lesions.Cancer US
  • CYST
    • a breast cyst is anechoic (meaning ‘black’ on the inside) signifying fluid.  The sound waves of the ultrasound machine, are easily transmitted through the fluid, giving this black appearance.  When the sound ‘hits’ the back was of the cyst, it produces a brightness (enhancement) – see yellow arrow in picture below.  Both of these features are classic for a breast cyst.Breast Cyst
    • a solid mass/lesion in the breast, does not have a ‘black’ interior, but, somewhat grey.  This is because the sound waves, emitted by the ultrasound, are not as easily transmitted through the lesion, due to the tissue within the mass.  More typical of benign (non-cancerous) masses, there may be enhancement and a lack of shadowing (see suspicious masses).  Nonetheless, the finding of a solid mass, regardless of it’s features, should prompt additional work up, even biopsy.brst-us-fib

Breast ultrasound as a screening modality can be done via a traditional hand-held technique or can implement an automated system whereby the ultrasound is done ‘robotically’. Like traditional ultrasound, ABUS (automated breast ultrasound) uses high-frequency sound waves targeted at the breast, but the scans provide physicians with a 3-D volumetric image of the entire breast. These 3-D images are more beneficial to women within the dense breast population because they allow radiologists the ability to check the breast from a variety of angles and offer a better interpretation. ABUS exams are also much shorter than traditional ultrasound, with some systems taking as little as seven minutes to perform a bilateral exam — less than half the time of some traditional ultrasounds.