October 20, 2021Breast health

Breast ultrasound : why?

Everyone is familiar with the ultrasound exam, where a small amount of cold gel is applied to a woman’s round belly, and soon she sees the first images of her unborn child. But did you know that this same device can be used in the breast cancer diagnosis process? It is called a breast ultrasound.

What is a breast ultrasound?

Ultrasound uses high-frequency sound waves to produce images of the inside of the breast. As with mammography, only a medical imaging technologist, or a doctor, can perform this examination. You need a prescription from your doctor to have a breast ultrasound.

How does it work?

The ultrasound machine, the probe, projects high-frequency sound waves onto the area being examined. These waves are then instantly translated into images visible on a screen. Rest assured, there are no risks associated with this examination and it is not painful at all.

Why a breast ultrasound?

The doctor may order a breast ultrasound before or after the mammogram.

Why before?

If the patient is young and has a suspicious lump, the doctor may order an ultrasound as the first investigative test. It should be remembered that breast cancer, although rare, is the most common type of cancer diagnosed during pregnancy .

Why after?

As a supplement to a mammogram that revealed an abnormality with a high risk of being cancerous. Ultrasound does not provide a definitive diagnosis of breast cancer, which is why all diagnostic tests are equally important. It does, however, provide additional information to help determine whether or not the patient has breast cancer and what the treatment plan will be. Ultrasound may also be used during the biopsy to guide the radiologist during the exam.

Ultrasound can provide images that mammography cannot, such as defining the nature of a mass, i.e., whether it is liquid or solid. Tumours are usually solid masses, which mammography cannot detect but ultrasound can. This difference may mean that the doctor will recommend further investigations, such as biopsy. In any case, ultrasound is always used as a complementary examination in the pre-diagnosis process. It provides more information about the nature of the abnormality detected, in order to determine whether further investigations are necessary.

How do I prepare for a breast ultrasound?

There is no need to prepare yourself for an ultrasound. The only advice would be to dress in clothes that are easy to remove from the top, as the examination is performed with the shirt off. It is also recommended that you avoid applying skin creams before the examination so as not to adversely affect the quality of the images.

How is the breast ultrasound performed?

The medical imaging technologist or radiologist will ask you to lie down on a table and bare your breasts. He or she will then apply a lubricating gel to the area to be examined, and then slide the probe over the skin, which will project images of the inside of the breast on a screen. The specialist will then take images of the area to be examined. The whole process takes only 10 to 20 minutes! You can return to your normal activities afterwards, as there are no side effects associated with the breast ultrasound.

What do the results mean?

As with mammography, the medical imaging technologist uses the BI-RADS ® (Breast Imaging-Reporting and Data System) classification.

  • BIRADS 0 :  Waiting classification, when further investigations are required,
  • BI-RADS 1 : Normal mammography,
  • BI-RADS 2 : There are benign (i.e., not serious) abnormalities that do not require further monitoring or investigation
  • BI-RADS 3 : There is a probably benign abnormality for which short-term surveillance (3 or 6 months) is advised,
  • BI-RADS 4 : There is an undetermined or suspicious anomaly,
  • BI-RADS 5 : There is an abnormality suggesting cancer.

This categorization will enable the doctor to determine what the next steps are and whether close follow-up or further investigations are necessary.

What is important to know is that breast ultrasound is a complementary examination to mammography. It makes it possible to better assess the nature of an abnormality that was detected in another way. However, always remember that a biopsy is, sometimes, the sole test that can make a definitive diagnosis of breast cancer. The examinations that precede it are only steps to determine whether or not it is necessary to investigate further. If you have a symptom that is worrying you, speak to your doctor, who will be able to guide you.

If you have any questions or concerns about breast cancer, we are here for you, before, during and after diagnosis and treatment. Don’t hesitate to call us. A professional will answer you confidentially: 1 855 561-PINK. 

We would like to thank OTIMROEPMQ for helping to write this article.

BIBLIOGRAPHY D’Orsi, C.J., Sickles, E.A., Mendelson, E.B., Morris, E.A. et al. “ACR BI-RADS® Mammography. In: ACR BI-RADS® Atlas, Breast Imaging Reporting and Data System.”American College of Radiology, 2013. Quebec Breast Cancer Foundation. “Breast cancer diagnosis.” Ruban rose (blog). Viewed October 14, 2021. https://rubanrose.org/en/inform-me/screening-and-diagnosis/breast-cancer-diagnosis /. Quebec Breast Cancer Foundation, “Le cancer du sein associé à la grossesse (Pregnancy-related breast cancer),” 2018, https://rubanrose.org/wp-content/uploads/2020/06/2019__depliant_grossesse_fr.pdf. Government of Quebec, “Les indications de l’échographie mammaire (Indications for breast ultrasound),” Ministère de la santé et des services sociaux, 2017, 2.

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