Breast ultrasound is a breast imaging test that uses high-frequency sound waves to produce images of the inside of the breasts. This test can be used to detect changes in the breast tissues and surrounding structures that may not be picked up by other screening tests, like mammograms. Ultrasound is often recommended for women under age 25 or those whose breast tissue is denser, making it more difficult to detect lumps or tumors with mammography.
This article explores what breast ultrasound involves, when and how it may be used, and what to expect if your doctor calls for one.
A breast ultrasound may be used in several ways. In many cases, it helps reveal breast abnormalities that mammography cannot easily detect. Although older women’s breasts tend to have a fattier composition (less density), younger women’s breasts are often denser. Dense breast tissues (and milk glands) may resemble cancerous tumors on a mammogram. Ultrasound can help detect breast lumps through this dense tissue more clearly than a mammogram.
In particular, breast ultrasound can help your health care team detect any changes in your breasts, such as the appearance of fluid-filled cysts and palpable lumps (breast lumps that can be felt under the skin). Your doctor may recommend the test if you feel an abnormality like a new breast lump or if a mammogram has detected a change in your breasts but could not produce a clear enough image.
Ultrasound can be used to assess the health of your breasts by examining how well your blood is flowing through the different areas of the tissues. This test can help find a blockage.
Breast ultrasound can also be used to guide surgical procedures, such as breast biopsies or cyst removals. A doctor may use ultrasound to help guide the needle used to extract a tissue sample for testing. This procedure is known as an ultrasound-guided breast biopsy.
Because it does not involve radiation exposure, ultrasound is also frequently used as a safer alternative to mammography (which does use radiation) for pregnant women. Radiation may harm the unborn baby.
Ultrasound imaging is not typically used in the detection of breast cancer by itself, as it may not pick up some of the earlier signs of the disease. For example, tiny deposits of calcium (microcalcifications) are easily visible in mammograms but usually do not show up on ultrasound images. In many cases, calcium deposits are benign (noncancerous), but they can also be an early marker for breast cancer.
Instead, ultrasound is used alongside other breast cancer screening tests. As one MyBCTeam member shared, “I never felt a lump or had any tenderness in my breasts. Ultrasounds picked it up when it first looked suspicious, and then they followed it for a few years. When it continued to grow and spread, they did the biopsies.”
If you detect a change in your breast, such as a new lump, during a self-exam or mammography, a breast ultrasound can provide your health care team with more information about the change. The test can help determine whether a breast lump is solid (which may indicate cancer or a noncancerous fibroadenoma) or filled with fluid (which likely indicates a benign growth, such as a cyst). It is important to note that ultrasound on its own cannot detect whether a solid mass in the breast is cancerous (malignant) or benign.
Ultrasound is a relatively easy, noninvasive, and painless procedure. Before a breast ultrasound, a clear gel is applied to the skin of the breast to be examined. A device known as a transducer is then moved over the skin of the breast. The transducer emits high-frequency sound waves that bounce off the tissues in the breasts. As these sound waves bounce off the breast tissue, they produce images that are displayed on a computer screen.
If your doctor would like to assess the blood flow in your breast, they will use an additional device, known as a Doppler probe, to listen to the sound waves emitted by the transducer. The Doppler will allow them to hear the speed and direction of your blood flow and identify any blockages that may be present.
One type of ultrasound, known as an automated breast ultrasound (ABUS), can be used to take hundreds of images at a time of almost the entire breast. In most cases, a second ultrasound must be performed after an ABUS to produce pictures of specific areas of the breast that cause concern.
If your doctor has requested a breast ultrasound, they will provide you with directions to follow before the procedure and on the day of the procedure. They will be able to advise you on what to do and what not to do before the procedure. Ask the provider performing the ultrasound any other questions you may have before you begin.
Your breast ultrasound may be conducted inpatient during a hospital stay or as an outpatient visit. Unlike some other tests (like some blood tests, for example), you do not need to stop eating or drinking before an ultrasound.
As Johns Hopkins Medicine advises, avoid using any powders, lotions, or other substances on the skin of your breasts on the day of your ultrasound. It is a good idea to wear clothing that can be easily removed or that will allow the doctor to access the breast being examined. You will likely be given a hospital gown to wear, as well.
Life with breast cancer is full of ups and downs. Having a team by your side can make a world of difference. MyBCTeam is the social network for women with breast cancer and their loved ones. Here, more than 53,000 women from across the globe come together to offer support and advice, share stories, and meet others who understand life with breast cancer.
Have you had a breast ultrasound done before? Share your thoughts or experiences in the comments below or by posting on MyBCTeam.