A breast ultrasound is a second-line radiological examination of the breast, the reference examination being mammography. It has several indications and can be performed in women of any age. The point with Dr Catherine Maestro, radiologist-senologist.
Definition: what is a breast ultrasound?
A ultrasound is a imaging technique that uses ultrasound to create real-time images of body organs. Breast ultrasound produces images of the inside of the breast. “We use a probe ultrasound high frequency because it is a superficial organ, such as the thyroid for example. Ultrasound makes it possible to explore the breast over 4 cm in thickness” describes Dr. Catherine Maestro, radiologist-senologist. “The smaller the breast, the higher frequency we use” she clarifies. “In a second time, in complementary methods we can use the doppler color which studies the vascularization or elastography informing about the elasticity of a lesion“adds the radiologist.
What is the difference between a breast ultrasound and a mammogram?
“Unlike the mammographybreast ultrasound does not use x-rays” informs Dr. Catherine Maestro. The ultrasound is therefore not radiating. “This technique is harmless“explains the radiologist. This makes it possible to repeat the ultrasounds”while we think a lot before doing close mammograms“. “Another difference between ultrasound and mammography: ultrasound is a real-time examination. We manually manipulate the probe and see the images of the lesions according to different levels of cuts and incidences of the ultrasound beam on the screen and we analyze them at the same time. During a mammogram, you have to wait for the images to be sent to a console to be analyzed.“says Dr. Maestro.
Indications: why do a breast ultrasound?
The indications for breast ultrasound are essentially diagnostic. “A breast ultrasound may be prescribed for a young woman or adolescent who presents a mass-like clinical abnormality or breast discharge“ teaches Dr. Maestro. “The young breast being very sensitive to irradiation, it is an ultrasound which is made in the adolescent girls and young women and not a mammogram” explains the radiologist. “An ultrasound can also be performed on a woman of any age who has palpable mass or abnormality during an individual or screening mammogramsays the doctor.In women who have a breast density high (dense breasts), a breast ultrasound is done to complete the mammography which is less effective in this case” informs Dr. Maestro who specifies that in a third of cases an additional breast ultrasound is necessary. Breast ultrasound is also the diagnostic examination of a abscess be youin a breastfeeding woman for example. “Breast abscess is also common in women who smoket“says Dr. Maestro. A breast ultrasound is performed as part of the bilan d’extension breast cancer. “If a mammogram has detected an abnormality in one breast, a breast ultrasound can explore that breast and the contralateral breast, which can help find additional or bilateral lesions, but also explore lymph nodes“explains the radiologist. Breast ultrasound also contributes to the diagnosis of recurrence of cancer be you or treatment complications (scarring cysts, hematomas, etc.). “Post-breast cancer monitoring is done by annual mammography and most often by mammography and ultrasound” indicates the radiologist. Finally, breast ultrasound is also recommended in patients who are breast prosthesis wearers undergoing screening and during follow-up to detect an anomaly on a prosthesis or a leak.
At what age should a breast ultrasound be done?
A breast ultrasound can be done at any age. It can even be done at little boys or little girls who present gynecomastia. This is the examination that is preferred for exploring the breast in young girls and young women because it is a technique that does not use X-rays unlike mammography.
A breast ultrasound is an examination that takes place in supine (lying on your back), arms raised under your head. The radiologist then applies a gel on the breasts to allow good contact between the skin and the ultrasound probe. The radiologist move the probe to examine each sector of one breast then the other (bilateral ultrasound). The duration of the exam is 10 to 20 mins.
What is a normal breast ultrasound?
A normal breast ultrasound is an ultrasound which showed no abnormalities. “A breast ultrasound can help determine if an indeterminate abnormality on the mammogram is benign (cyst simple) or not“says Dr. Maestro.”If the mass is probably benign and not cystic, monitoring is carried out“ she completes.
What is an abnormal breast ultrasound?
A breast ultrasound can confirm an abnormality detected during the mammogram, the ultrasound making it possible to study the structure, shape, contours and vascularization of the lesion. “In this case, if we have criteria of suspicion, we continue the explorations“says Dr. Catherine Maestro.
How reliable is a breast ultrasound?
“The reference examination for the breast is mammography. Ultrasound most often completes a mammogram and the correlation between the mammographic and ultrasound aspects makes it possible to establish a score of suspicion and to approach a diagnosis.” answers Dr. Maestro. Its ability to detect breast cancer is interesting in women with high breast density: lcombination of ultrasound with mammography increases breast cancer detection by at least 15% dense. In the event of an anomaly being detected, it is the biopsy guided by ultrasound which will make it possible to make the diagnosis.
What are the contraindications for a breast ultrasound?
There is no contraindication to a breast ultrasound. Ultrasounds in general are non-invasive and non-irradiating and are even performed during pregnancy.
Breast ultrasounds can be performed during pregnancy
What is the price of a breast ultrasound and is it reimbursed?
The cost of a breast ultrasound is 41,58 euros. The refund by the Social Security accounts for 70% of the conventional tariff as part of the care pathway. Exceeding fees can be covered by mutual insurance.
Thank you to Dr Catherine Maestro, radiologist-senologist at the Center Hospitalier d’Antibes, former head of service at the Center for the Fight Against Cancer (CLCC) in Nice.