Breast Ultrasound

Ultrasound imaging of the breast produces a picture of the internal structures of the breast.

Doppler ultrasound is a special ultrasound technique that evaluates blood velocity as it flows through a blood vessel, including the body's major arteries and veins in the abdomen, arms, legs and neck.

During a breast ultrasound examination the sonographer or physician performing the test may use Doppler techniques to evaluate blood flow or lack of flow in any breast mass. In some cases this may provide additional information as to the cause of the mass.

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. Supplemental screening ultrasound is usually only considered for women at high risk for breast cancer when the breast tissue is dense. 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:

  • Are at high risk for breast cancer and unable to tolerate an MRI examinations.
  • Are at intermediate risk for breast cancer based on family history, personal history of breast cancer, or prior biopsy showing an abnormal result.
  • 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.

Several types of automated devices have been developed for whole breast ultrasound. Further evaluation of such approaches is needed.

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.

Learn More About Ultrasound-Guided Breast Biopsy