This chapter will review the utilization of breast ultrasound for screening and diagnostic purposes. Currently, ultrasound is primarily used to investigate palpable lesions in women less than 30 years old, to provide further characterization of abnormal mammographic findings, and to guide invasive breast interventions. Innovations in ultrasound technology have improved the detection and diagnosis of breast cancer.
Each year, thousands of younger women with no known risk of breast cancer get mammograms before having breast reduction surgery. Patients receive the exam, often at the suggestion of their doctors, when the best recommendation says to avoid routine mammograms before elective breast surgery unless a specific concern exists. Although the pre-surgical screening has been a longtime practice among physicians, no professional society recommends routine screening until a woman turns
A core needle biopsy uses a long, hollow tube to extract a sample of tissue. Here, a biopsy of a suspicious breast lump is being done. The sample is sent to a laboratory for testing.
If your institution subscribes to this resource, and you don't have a MyAccess Profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus. The role of ultrasound in breast care has expanded considerably over the past 30 years. While in its infancy, it was used mainly to distinguish cystic from solid masses, it has evolved to be an essential component of state-of-the-art breast care for the breast surgeon.
The utilization of intraoperative ultrasound IOUS in breast cancer surgery is a relatively new concept in surgical oncology. Over the last few decades, the field of breast cancer surgery has been striving for a more rational approach, directing its efforts towards removing the tumor entirely yet sparing tissue and structures not infiltrated by tumor cells. Further progress in objectivity and optimization of breast cancer excision is possible if we make the tumor and surrounding tissue visible and measurable in real time, during the course of the operation; IOUS seems to be the optimal solution to this complex requirement.
Its versatility as a guidance tool also extends to cyst aspiration, core needle biopsy, needle localisation, and placement of brachytherapy devices. Intra-operative ultrasound does not require the sophisticated equipment needed for diagnostic ultrasound because it functions as a guidance tool during surgery. More breast surgeons in Europe use ultrasound than those in North America.
The two hyperechogenic spots arrowswith reverberation artifacts, are the metallic surgical clips placed within the operative bed at the time of lumpectomy. The lumpectomy site is marked by the surgeon with metallic clips for radiation therapy planning, especially for electron boost irradiation. Generally, clips are used to outline the excision cavity.
Surgeons are increasingly using ultrasound for visual guidance, both in an interoperative setting, to help ensure a clean cut around the tumour, and also to guide breast biopsies. Radiologists however are warning that performing and interpreting ultrasound scans can be trickier than is often assumed and that, in untrained hands, ultrasound could harm patient care. They worry in particular that, if surgeons get an official go-ahead to use ultrasound to help them visualise tumours, there is nothing to stop them also misusing the technique, eg to screen for or characterise lesions, which requires multimodal imaging and great expertise. Should surgeons ever be allowed to use ultrasound?
During a clinical breast exam, your doctor will check both breasts for lumps and other problems. Some fibroadenomas are too small to feel, so they can only be discovered in imaging tests. If you have a lump that can be felt palpableyour doctor might recommend certain tests or procedures, depending on your age and the characteristics of the lump.
Top of the page. A breast ultrasound uses sound waves to make a picture of the tissues inside 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. Breast ultrasound does not use X-rays or other potentially harmful types of radiation.