Breast Ultrasound

Breast ultrasound is a non-invasive imaging technique used to examine the internal structures of the breast.

Dr Jesse Hu
Consultant General Surgeon, Breast, Thyroid & Endocrine Surgery

What Is Breast Ultrasound?

Breast ultrasound is an imaging test that uses high-frequency sound waves to produce detailed images of the breast tissue. It helps to distinguish between solid masses and fluid-filled cysts, providing additional information about the internal structure of a breast lump.

Indications for Breast Ultrasound

Breast ultrasound is primarily used to evaluate further abnormalities detected by mammography or during physical examinations. It is particularly useful in the following scenarios:

Differentiating Between Solid and Cystic Masses

Ultrasound is highly effective in distinguishing between solid tumours, which may be benign or malignant, and cysts, which are typically benign.

Assessing Palpable Breast Abnormalities

Ultrasound can help determine the cause and define the characteristics of palpable lumps, pain, or nipple discharge in patients. This is especially important in younger women, where dense breast tissue can make mammograms less effective.

Supplementing Mammography

In women with dense breast tissue, ultrasound can be used as an adjunct to mammography because it can provide clearer images of the breast tissue. Dense tissue appears white on a mammogram, which can mask abnormalities that also appear white.

Guiding Breast Procedures

Ultrasound is instrumental in guiding procedures such as biopsies and needle aspirations, as it provides real-time images that allow precise needle placement for sampling breast tissue or draining cysts.

Evaluating Breast Implants

Ultrasound can assess the integrity of breast implants and detect complications such as ruptures or the presence of fluid collections around the implant.

Preparing for a Breast Ultrasound

Here are the key steps and considerations for preparing for a breast ultrasound:

Schedule Timing

It is often recommended to schedule the ultrasound one week after menstruation begins. This timing is chosen because the breasts are usually less tender and swollen, providing clearer images and a more comfortable experience for the patient.

What to Wear

Patients should wear comfortable, loose-fitting clothing to the appointment. They may be asked to undress from the waist up and wear a gown during the procedure, so clothing that is easy to remove is ideal.

Avoiding Certain Products

Before the ultrasound, it is advisable to avoid using deodorant, talcum powder, or lotion on the breasts or under the arms. These products can contain particles that might be visible on the ultrasound images and could be mistaken for abnormalities.

Medication and Health History

Patients should inform the technician or radiologist about medications they are taking and any relevant health history. This information can help interpret ultrasound results accurately.

The Breast Ultrasound Procedure

The breast ultrasound procedure is non-invasive and painless. Here is a detailed description of what to expect during a breast ultrasound:

The patient lies down on an examination table, and the area to be examined is exposed while the rest of the body remains covered. The patient may be asked to raise their arm above their head to allow better access to the breast tissue.

A clear, water-based gel is applied to the breast. This gel helps to eliminate air pockets between the transducer and the skin, which can interfere with the sound waves needed to create the images.

The radiologist or sonographer gently presses the transducer against the skin and moves it over the area of interest. The transducer sends and receives high-frequency sound waves that create live images of the breast tissues on a monitor.

The sonographer might occasionally pause to examine certain images more closely, sometimes capturing specific pictures for later review. Additional images or focus on specific areas may be necessary if any unusual findings are observed.

Once the examination is complete, the gel is wiped off, and the patient can get dressed. There are no post-procedure restrictions, allowing the patient to return to normal activities immediately.

The images from the ultrasound are reviewed by a radiologist, who interprets the data and compiles a report for the patient’s physician. The results are usually available within a few days, and a follow-up appointment may be scheduled to discuss the findings.

Limitations and Considerations

While breast ultrasound is a valuable diagnostic tool, it has certain limitations and considerations that must be taken into account:

Sensitivity and Specificity

  • Sensitivity: Although ultrasound is excellent for detecting and evaluating breast lesions, it may not detect all types of breast cancer, especially those that are small or located deep within the breast tissue.
  • Specificity: Ultrasound can sometimes lead to false positives, where benign conditions are mistaken for malignant ones, potentially leading to unnecessary anxiety and further testing.

Breast Density

Ultrasound is beneficial in women with dense breast tissue, whereas mammograms are less effective. However, the interpretation of ultrasound can still be challenging in highly dense breasts, potentially masking some abnormalities.

Not a Standalone Tool

Breast ultrasound is generally not used as a standalone screening tool for breast cancer. It is most effective with other methods like mammography, especially for routine screening in the general population.

These limitations highlight the importance of using breast ultrasound as part of a comprehensive diagnostic approach to ensure that all potential issues are adequately addressed.

Dr Jesse Hu

Consultant General Surgeon, Breast, Thyroid & Endocrine Surgery

Dr Jesse specialises in managing both benign and malignant breast and thyroid conditions, which also includes breast pain, breast lumps, breastfeeding problems, neck lumps, amongst others.

Her dual expertise in cancer removal and plastic surgery techniques expands the design of individualized treatments, leading to holistic patient outcomes.

Dr Jesse was part of the teaching faculties of both NUS Yong Loo Lin School of Medicine and Lee Kong Chian School of Medicine, where she teaches and mentors the next generation of medical students and trainee doctors.

  • Surgical training at NUS School of Medicine
  • FRCS (Fellow of the Royal College of Surgeons) Edinburgh, UK in 2014
  • Completed 2 Health Manpower Development Program (HMDP) fellowships at Oxford University Hospital, UK in 2016

Dr Jesse is recognized as an authority in breast cancer and thyroid surgery and a sought-after conference speaker.

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    Breast Ultrasound

    Frequently Asked
    Questions

    Is breast ultrasound safe during pregnancy?

    Breast ultrasound is safe during pregnancy as it uses sound waves instead of radiation to create images. It is a preferred method for examining breast concerns in pregnant women.

    How often should I have a breast ultrasound?

    The frequency of breast ultrasounds depends on the person’s risk factors and existing breast conditions. For those with high-risk factors for breast cancer or previous breast abnormalities, a doctor may recommend more frequent ultrasounds along with other screening methods.

    What is the difference between a screening and a diagnostic breast ultrasound?

    A screening ultrasound is used to check breasts when no symptoms are present, often as a complement to mammography. A diagnostic ultrasound investigates a known or suspected problem, such as a lump or abnormal mammogram results.

    Are there any side effects associated with breast ultrasound?

    Breast ultrasound has no known harmful effects and involves no radiation exposure, making it a safe option for repeated use.

    How should I choose between a mammogram and an ultrasound?

    The choice between these two tests should be made based on your age, breast density, risk factors for breast cancer, and any specific symptoms. This decision is best made in consultation with a breast surgeon who can recommend the most appropriate screening strategy for your situation.