Breast Ultrasound

By Emma Hitt

(Breast Ultrasonography, Breast Sonogram, Mammographic Ultrasound, Sonomammography, Ultrasound Mammography)

Procedure overview

What is breast ultrasound?

Breast ultrasound is a noninvasive (the skin is not pierced) procedure used to assess the breasts. Ultrasound technology allows quick visualization of the breast tissue. Ultrasound may also be used to assess blood flow to areas inside the breasts. The examination is often used along with mammography.

Breast ultrasound uses a handheld probe called a transducer that sends out ultrasonic sound waves at a frequency too high to be heard. When the transducer is placed on the breast at certain locations and angles, the ultrasonic sound waves move through the skin and other breast tissues. The sound waves bounce off the tissues like an echo and return to the transducer. The transducer picks up the reflected waves, which are then converted into an electronic picture of the breasts.

Different types of body tissues affect the speed at which sound waves travel. Sound travels the fastest through bone tissue, and moves most slowly through air. The speed at which the sound waves are returned to the transducer, as well as how much of the sound wave returns, is translated by the transducer as different types of tissue.

Prior to the procedure, clear, water-based gel is applied to the skin to allow for smooth movement of the transducer over the skin and to eliminate air between the skin and the transducer.

By using an additional mode of ultrasound technology during an ultrasound procedure, blood flow within the breast can be assessed. An ultrasound transducer capable of assessing blood flow contains a Doppler probe. The Doppler probe within the transducer evaluates the velocity and direction of blood flow in the vessel by making the sound waves audible. The degree of loudness of the audible sound waves indicates the rate of blood flow within a blood vessel. Absence or faintness of these sounds may indicate an obstruction of blood flow.

Ultrasound may be safely used during pregnancy or in the presence of allergies to contrast dye, because no radiation or contrast dyes are used.

More recent ultrasound technologies, such as three-dimensional (3D) and four-dimensional (4D) ultrasound, tissue harmonic imaging (uses the harmonic signal generated by tissue itself), ultrasound contrast agents, and ultrasound elastography (low-frequency vibration technique used to evaluate movement of breast lesions), show promise for diagnosing cancerous breast lesions in a noninvasive manner.

Related procedures that may be performed to evaluate breast problems include mammography, breast biopsy, and breast scan. Please see these procedures for more information.

Anatomy of the breasts

Each breast has 15 to 20 sections, called lobes, which are arranged like the petals of a daisy. Each lobe has many smaller lobules, which end in dozens of tiny bulbs that can produce milk.

The lobes, lobules, and bulbs are all linked by thin tubes called ducts. These ducts lead to the nipple in the center of a dark area of skin called the areola. Fat fills the spaces between lobules and ducts.

There are no muscles in the breast, but muscles lie under each breast and cover the ribs.

Each breast also contains blood vessels and vessels that carry lymph. The lymph vessels lead to small bean-shaped organs called lymph nodes, clusters of which are found under the arm, above the collarbone, and in the chest, as well as in many other parts of the body.

Reasons for the procedure

A breast ultrasound procedure is commonly performed to determine if an abnormality detected by mammography or a palpable lump is a fluid-filled cyst or a solid tumor (benign or malignant). Breast ultrasound may also be used to identify masses in women whose breast tissue is too dense to be measured accurately by mammography. Breast ultrasound is generally not used as a screening tool for breast cancer detection because it does not always detect some early signs of cancer such as microcalcifications, which are tiny calcium deposits.   



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