What is the role of ultrasonography (US) in the evaluation of breast cancer?

Updated: Feb 01, 2017
  • Author: Paul R Fisher, MD; Chief Editor: Eugene C Lin, MD  more...
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Answer

Ultrasonography (US) has been playing an increasingly important role in the evaluation of breast cancer. US is useful in the evaluation of palpable masses that are mammographically occult, in the evaluation of clinically suspected breast lesions in women younger than 30 years of age, and in the evaluation of many abnormalities seen on mammograms. Some breast imagers believe that US is the primary modality for the evaluation of palpable masses in women 30 years of age and older and that mammography plays an adjunctive technique. US is also useful in the guidance of biopsies and therapeutic procedures; research is currently under way to evaluate its role in cancer screening. [1, 2, 3, 4, 5, 6]

See the image below.

Breast cancer, ultrasonography. Mediolateral obliq Breast cancer, ultrasonography. Mediolateral oblique digital mammogram of the right breast in a 66-year-old woman with a new, opaque, irregular mass approximately 1 cm in diameter. The mass has spiculated margins in the middle third of the right breast at the 10-o'clock position. Image demonstrates both the spiculated mass (black arrow) and separate anterior focal asymmetry (white arrow).

See Breast Lumps in Young Women: Diagnostic Approaches, a Critical Images slideshow, to help manage palpable breast lumps in young women.

Originally, ultrasonography was primarily used as a relatively inexpensive and effective method of differentiating cystic breast masses from solid breast masses. However, it is now well established that US also provides valuable information about the nature and extent of solid masses and other breast lesions.

Ultrasonography does not expose a patient to ionizing radiation — a factor that is particularly important for pregnant patients and young patients. It is believed that in these patients, the breast is more sensitive to radiation; this would mean that in comparison with US, mammography would be associated with a slight increase in the small risk of acquiring radiation-induced neoplasm. Furthermore, young women's breasts tend to appear dense on mammograms — a factor that reduces the diagnostic sensitivity of mammography in this group. In addition, breast US is superior to mammography in the evaluation of breast abscesses. [7, 8, 9]

The role of US in the screening of specific groups of patients, such as those with mammographically dense breasts and those at high risk for breast carcinoma, is under investigation. The role of breast magnetic resonance imaging is also expanding and is under study.

For patient education resources, see the Cancer Center. Also, see the patient education articles Mammogram, Breast Cancer, and Breast Lumps and Pain.


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