Breast Ultrasound - Why and When?

October is Breast Cancer Awareness month; The Breast Centre remains devoted to educating about Breast Cancer and
promoting its early detection. Screening is a tool that offers the most cost-effective long-term strategy for the control of
Breast cancer.

Screening for breast cancer with imaging modalities has been shown to decrease mortality from breast cancer, and
mammography still is the mainstay of screening for clinically occult disease. The American Cancer Society recommends an
annual screening mammogram for women over age 40. Screening mammograms have been proven to decrease mortality
from breast cancer by approximately 30%. Simply put, early detection of breast cancer saves lives.

Other imaging modalities including ultrasound and magnetic resonance imaging have been used as adjunctive screening
tools, mainly for women who may be at increased risk and in other instances what are discussed below.

What is Ultrasound? Ultrasound is an imaging test that uses

high frequency sound waves to create pictures of the insides
of your body. Breast ultrasound is not usually done to screen
for breast cancer, because it may miss some early signs of
cancer. More often, it is used as a diagnostic tool to follow up
on suspicious areas seen on a mammogram.

This test can also give more information about small areas of
interest within the breast that may be difficult to see in detail
on a mammogram or in case the breasts are dense. The
ultrasound may show whether a lump is solid or fluid-filled.

Why do you need an ultrasound? If your screening Mammogram result suspects or suggests cancer, then your doctor must
find out whether it is due to cancer or some other cause. Your doctor may ask about your personal and family medical
history and perform a physical exam. Then, your doctor may order additional exam like Ultrasound to evaluate further to
reach a diagnosis.

The ultrasound may show whether a lump is solid or filled with fluid. A cyst is a fluid-filled sac and pure cysts are not cancer.
However, a solid mass may be cancer and ultrasound may also help in differentiating a benign lump from cancerous one
and tell us if it needs biopsy. Finally, ultrasound also is used to guide the biopsy needle.

When do you need Ultrasound? There are many indications where your doctor may order Breast Ultrasound.
a) To follow up suspicious areas seen on the screening/diagnostic Mammogram (Abnormal mammogram)
b) To differentiate between a cyst and solid lump, when a lump is felt on examination (Diagnostic)
c) When the Breasts are dense on the Mammogram (Supplemental tool with mammogram)
d) In women at high risk, eg: family history of cancer (supplemental screening tool with mammogram)
e) Younger women (under 30) with breast symptoms (diagnostic)
f) Examining a pregnant women with breast symptoms (to avoid radiation)
g) Guiding a needle into the lump for tissue biopsy

Once the breast ultrasound is done, the radiologist then interprets the images and reports the results to your doctor. The
radiologist will also recommend if any additional tests or follow ups are needed.

Remember, Breast Ultrasound uses sound waves to produce images and no radiation is involved. Hence, there are no
known risks of using ultrasound technology. It is a safe and painless diagnostic test to mainly examine targeted areas of
abnormal breast tissue on mammogram. Breast ultrasound provides detailed images of breast tissue and can help your
doctor diagnose breast cysts or solid lumps. It is also used as an adjunctive screening tool (with mammograms) in high risk
patients and in patients with dense breasts. It is also a preferred exam in young women and in pregnancy.

The Breast Centre at the Medical Pavilion Bahamas offers Prompt, Professional, and Private Ultrasound services. Visit us
today.

Dr Amaresh Hombal MBBS, MD

Consultant Radiologist
The Breast & Imaging Centres
at The Medical Pavilion Bahamas