How are patients positioned for breast ultrasonography?

Updated: Jan 24, 2017
  • Author: Durre Sabih, MBBS, MSc, FRCP(Edin); Chief Editor: Mahan Mathur, MD  more...
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Answer

Answer

Generally the following positions are used:

  • Medial lesions: The patient is supine, with the ipsilateral arm over patient’s head.

  • Lateral lesions: The patient is opposite posterior oblique, with the ipsilateral arm over the patient’s head. The degree of obliquity depends on the breast size, pendulousness, and the location of the lesion within the breast. In a large breast, a complete decubitus position might be the best.

  • If a lesion is superficially located and is palpable in the erect position, the patient should be examined, at least for a part of the procedure in this position. Remember that the breast appears thicker in the erect position, so this is not appropriate for posterior lesions.

  • Superior lesions: The patient is supine, opposite posterior oblique or sitting, with the ipsilateral arm over the patient’s head.

  • Inferior lesions: The patient is supine, and the breast can be held superiorly.

Varying degree of pressure is used to flatten the breast parenchyma as well as bring the conical surface of the glandular tissue into a more orthogonal plane.

Given the real-time dynamic nature of ultrasound imaging, and the tendency of the breast to change its shape with gravity, the patient position should be optimized to the examination. [8] This may be done several times to allow the acquisition of high-quality, reproducible images. Different positions are especially useful in large breasts. Inadequate positioning may cause portions of the breast to become inaccessible, the breast to fall over the transducer or the lesions to appear displaced on follow-up examinations. Small breasts with little soft tissue to glide over the chest wall can be examined in the supine position.


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