Breast Cancer Ultrasound
If you have noticed a change in your breasts or a mammogram has detected an abnormality, your doctor may arrange a breast ultrasound for you. A breast ultrasound is a non-invasive, painless test that uses sound waves to form an image of structures in the breast, which helps your healthcare provider determine whether these changes are caused by a non-cancerous or benign lump of tissue or a breast cancer based upon the shape, location and other characteristics visible on ultrasound. Occasionally the ultrasound can be inconclusive, and your doctor may request follow up ultrasound to monitor the lump and/or request a biopsy.
Can ultrasound detect breast cancer? Yes, however, some ultrasounds may be inconclusive and there may be other tests your doctor requests you to take in addition to the ultrasound, such as a biopsy to deliver a full diagnosis.
To detect abnormalities in the breast, ultrasound machines send high-frequency sound waves towards the tissue while receiving those waves that echo/bounce back. The images of the breast tissue are created by these reflected sound waves, which are dependent on the internal structures of your breast/s such as boundaries between fluid and soft tissue or between bone and soft tissue.
Common Uses of Breast Cancer Ultrasounds
If you notice any changes in your breasts, or feel any new lumps during a self-check, it’s essential to visit your doctor first. Your doctor will examine you and may require you to undergo a breast ultrasound.
Breast ultrasounds may be used for a number of reasons, and are most commonly used to determine whether a breast lump is solid and therefore potentially a tumour or if it contains fluid such as a cyst, which is mostly benign. However, tumours can be solid and liquid-filled at the same time. It’s important to note that a breast ultrasound cannot always determine if a solid lump is cancerous.
A breast ultrasound may be used if an individual has particularly dense breast tissue. In this case, a mammogram may not be able to capture a complete picture of the normal breast tissue and potential abnormalities, while a breast ultrasound can give a more detailed image.
The Breast Ultrasound Procedure
A breast cancer ultrasound is a quick and completely painless procedure. Ahead of your breast ultrasound, make sure to have your referral letter from your doctor with you, along with any previous scan results that may be relevant. You will want to wear clothes that are easy to remove. Leave jewellery and valuables at home and avoid putting any lotions, creams or other products on the areas to be scanned.
To begin, you will be asked to remove your clothing from the waist up. The sonographer, the medical professional administering your breast ultrasound, will spread gel on the area/s to be scanned. They will then move a small device called a transducer over your breast and the lymph nodes in your armpit.
The transducer is connected to a computer and sends high-frequency sound waves into the breast tissue. As these waves bounce back, or echo, images appear on the monitor.
The sonographer may need to press or apply pressure, but there shouldn’t be any pain, and the scan should only take about 15-20 minutes.
Ultrasound is also a safer screening option for women who are pregnant, as it doesn’t use radiation, and is also a commonly used screening method for patients aged under 25.
Results of a Breast Ultrasound
Cysts, lumps and tumours will all appear as darker spots on your ultrasound images, compared to the lighter grey and white tissue of the breast. However, a darkened area does not necessarily indicate cancer. Fluid-filled benign cysts and non-cancerous lumps can also be detected by an ultrasound.
What does breast cancer look like in an ultrasound?
Fluid-filled cysts usually appear as solid black circles or ovals, while compared to cysts, breast cancers usually appear as slightly lighter irregular masses. It is important, however, not to try to interpret breast cancer ultrasound images on your own. Your healthcare professional is trained to know what to look for and will talk you through any next steps.
Breast cancer shows up as a darker patch on the otherwise lighter grey or white tissue around it. This is because the sound waves will bounce off a solid tumour. Surrounding tissue will be interpreted by the computer as a lighter-coloured image with the tumour mass appearing darker than surrounding healthy tissue such as air and bone.
An ultrasound can detect potential breast cancers, however, it cannot determine whether a solid lump is cancerous or not – only whether a lump is solid (a tumour or benign), filled with fluid or both. An ultrasound may also fail to detect small lumps and cannot pick up small deposits of calcium that can indicate breast cancer. If a solid, potentially cancerous tumour appears in your breast cancer ultrasound, your doctor will require further testing for a complete diagnosis.
This will depend on where you have the scan done, but in most cases, your results will be sent to your GP, or the doctor who referred you for the breast ultrasound. You will need to book a follow-up appointment with them to discuss results. The radiology centre or hospital administering your ultrasound should be able to give you a guide as to how long results will take to reach your primary healthcare provider – typically within a few days.
For breast cancer, an ultrasound is highly accurate, with research suggesting it can correctly detect around 80% of breast cancers. It is useful in the detection and diagnosis of breast cancer, but as it cannot indicate whether a solid mass in the breast is cancerous or benign, it is usually used alongside other tests.