Breast Sonography
What
is Breast Sonography?
Breast
sonography utilizes sound waves to acquire images of the breast. A
breast ultrasound can show all areas of the breast, including the
area closest to the chest wall, which is hard to study with a
mammogram.
Ultrasound scanning of the breast, involves using high-frequency
sound waves to produce images of the breast tissue.
Breast sonography
is a new specialty registry available to sonographers and students.
Breast sonography is most frequently used to better evaluate any
abnormality seen in a screening or diagnostic mammogram or during a
clinical breast exam performed by a physician. Ultrasound
allows images of the breast from almost any orientation. A
sonogram can efficiently determine if a suspicious area on a
mammography film is a cyst versus a solid mass. If a solid
mass is found, a biopsy is usually done under ultrasound guidance to
determine if the mass is benign or malignant.
There are many benefits of breast sonography:
-
After a mammogram, ultrasound can provide new clinical
information for women with dense breasts.
-
When breast masses or abnormalities are found, ultrasound is a
good choice for characterizing the mass.
-
Ultrasound, in most cases, can eliminate the need for a biopsy.
However, if a biopsy is necessary, ultrasound guidance is used
to ensure the correct tissue is being biopsied.
-
Breast
sonography does not use
X-rays
or other potentially harmful types of radiation.
-
Ultrasound has excellent contrast
resolution. This means, that an area of fluid (cyst) and an area
of normal breast tissue are easy to differentiate on an
ultrasound.
How is a
Breast Sonogram Performed?
For a breast
ultrasound, a small handheld instrument called a transducer is
passed back and forth over the breast. It sends out high frequency
sound waves (above the range of human hearing) that are reflected
back to the transducer. A detector analyzes the sound waves and
converts them into a picture that is displayed on a video monitor.
The patient will
be asked to undress from the waist up and gel will be placed on
their breast. To protect patient privacy a gown is
given to drape around your shoulders and the songrapher will use
towels to drape the breast as well.
The patient is asked to remove all jewelry from around the
neck. Gel is placed on the breast so the transducer can pick up the
sound waves as it is moved back and forth over the breast. A picture
of the breast tissue can be seen on a monitor.
The transducer will be pressed on the breast and an image will
appear on the screen. The sonographer will take diagnostic
images. A breast ultrasound exam usually takes between 15 and
30 minutes to complete. Additional time may be needed if a mammogram
will be done before the ultrasound or if a biopsy is also scheduled.
The patient may be asked to wait until a radiologist has reviewed
the images.
The radiologist may want to do more ultrasound views of some areas
of your breast.
Talk to your health
professional about any concerns you have regarding the need for the
test, its risks, how it will be done, or what the results will mean.
Some Common Uses
of Breast Sonography:
- Determining the
Nature of a Breast Abnormality
- The primary use of
breast ultrasound today is to help diagnose breast abnormalities
detected by a physician during a physical exam (such as a lump
or bloody or spontaneous clear nipple discharge) and to
characterize potential abnormalities seen on
mammography.
-
Ultrasound imaging can help to determine
if an abnormality is solid (which may be a non-cancerous lump of
tissue or a cancerous tumor) or fluid-filled (such as a
benign
cyst)
or both cystic and solid. Ultrasound can also help show
additional features of the abnormal area.
Doppler ultrasound is used to assess blood supply in breast
lesions.
- Supplemental Breast
Cancer Screening
Mammography is
the only screening tool for breast cancer that is known to reduce
deaths due to breast cancer through early detection. Even so,
mammograms do not detect all breast cancers. Some breast lesions and
abnormalities are not visible or are difficult to interpret on
mammograms. In breasts that are dense, meaning there is a lot of
glandular tissue and less fat, many cancers can be hard to see on
mammography.
Many studies have shown that ultrasound and magnetic resonance
imaging (MRI) can help supplement mammography by detecting small
breast cancers that may not be visible with mammography. This is
usually only considered when the breast tissue is dense. It is hoped
that by detecting such cancers, these other screening tests might
help to further prevent deaths due to breast cancer beyond what is
achieved with mammography alone. When ultrasound is used for
screening, many abnormalities are seen which may require biopsy but
are not cancer (false positives), and this limits its cost
effectiveness.
Today, ultrasound is being investigated
for use as a screening tool for women who:
- have dense breasts
- have silicone breast implants and very
little tissue can be included on the mammogram
- are pregnant or
should not to be exposed to
x-rays
(which is necessary for a mammogram)
- are at high risk for breast cancer based
on family history, personal history of breast cancer, or
prior atypical biopsy result.
Ultrasound-guided Breast Biopsy
When an ultrasound examination cannot characterize the nature of a
breast abnormality, a physician may choose to perform an
ultrasound-guided
biopsy.
Because ultrasound provides real-time images, it is often used to
guide biopsy procedures.
A breast biopsy involves removing some tissue—usually by a procedure
involving a needle which can take small pieces of tissue under local
anesthesia—from the suspicious area in the breast and examining it
under a microscope to determine a diagnosis. Occasionally, a
surgical biopsy is needed to make a diagnosis.
Ultrasound-guidance is used to assist physicians in obtaining tissue
samples from the breast in three different biopsy procedures: a cyst
aspiration, a fine needle aspiration (FNA) biopsy and a core needle
(CN) biopsy. Most cysts do not require any procedure. FNA is most
often performed to evaluate suspicious axillary lymph nodes (under
the arm) in patients with known or suspected breast cancer. Most
ultrasound-guided breast biopsies are performed using core or
vacuum-assisted needle biopsy techniques.
For more information
about earning potential and work environment for sonographers, visit the
Inside
Scoop.
Links:
-
Breast
Ultrasound Foundation The
Breast Ultrasound Foundation’s mission is to increase public and
professional awareness of the role of quality ultrasound in the detection
and management of breast cancer and in women’s health.
-
Society
of Diagnostic Medical
Sonographers The SDMS was founded in 1970 to promote, advance, and educate its members
and the medical community in the science of Diagnostic Medical Sonography.
-
American
Registry for Diagnostic Medical Sonographers ARDMS
is an independent, nonprofit organization that administers examinations
and awards credentials in the areas of diagnostic medical sonography,
diagnostic cardiac sonography and vascular technology.
-
Joint
Review Committee on Education in Diagnostic Medical Sonography The
mission of the JRC-DMS and its sponsoring organizations is to cooperate
to establish, maintain, and promote appropriate standards of quality
for educational programs in diagnostic medical sonography and to
provide recognition for educational programs that meet or exceed the
standards.
-
Commission
on Accreditation of Allied Health Education Programs CAAHEP
is the largest programmatic/specialized accreditor in the health
sciences field. In collaboration with its Committees on Accreditation,
CAAHEP reviews and accredits more than 2000 educational programs
in twenty-one health science occupations across the United States
and Canada.
Images:
 |
 |
 |
Ultrasound
image showing
adjacent breast masses:
one a simple cyst,
the other
debris filled. |
Colorflow
shows small
superficial vessels at the
nipple. |
Solid
irregular breast
mass with calcification
(calcium deposits). |
|
