Breast Ultrasound Health Article

Abnormal results

A potentially malignant mass can be identified by breast ultrasound. Abnormal results fall into the following categories: benign fibrous nodule, complex cyst, suspicious lesion, and lesion highly suggestive of cancer. In cases where ultrasound shows the presence of a complex cyst or fibrous nodule, a biopsy is justified because 10% to 15% of these growths are malignant. Lesions falling into the last two categories (suspicious or highly suggestive of cancer) have a higher chance of being cancerous, and should be investigated further, either by biopsy or surgery.

Breast cancers such as the following may be identified on ultrasound: ductal carcinoma, infiltrating lobular carcinoma, medullary carcinoma, mucinous (colloid) carcinoma, tubular carcinoma, and papillary carcinoma. On ultrasound, the shape of a lesion and the type of edges it has can sometimes indicate if it is benign or cancerous, but there are exceptions. For example, benign fibroadenomas are usually oval, and some cancers can be similarly shaped. Cancerous tumors usually have jagged edges, but some benign growths can have these edges as well. Ultrasound is not a definitive test. Tissue diagnosis is often required.

See Also Biopsy; Breast cancer; Breast self-exam

Resources

BOOKS

Love, Susan M., with Karen Lindsey. Dr. Susan Love's Breast Book. 2nd ed. Reading, MA: Addison-Wesley, 1995.

Rumack, Carol M. et al., ed. Diagnostic Ultrasound St. Louis:Mosby-Year-Book, Inc., 1998.

PERIODICALS

Jackson, Valerie. "The Current Role of Ultrasonography in Breast Imaging." Radiologic Clinics of North America 33 (November 1995): 1161-70.

Rubin, Eva, et al. "Reducing the Cost of Diagnosis of Breast Carcinoma: Impact of Ultrasound and Imaging-Guided Biopsies on a Clinical Breast Practice." Cancer 91 (January 2001) 324-31.

Smith, LaNette F. et al. "Intraoperative Ultrasound-guided Breast Biopsy." The American Journal of Surgery 180 (December 2000): 419-23.

Velez, Nitzet et al. "Diagnostic and Interventional Ultrasound for Breast Disease." The American Journal of Surgery 180 (October 2000): 284-7.

Ellen S. Weber

Cyst

—A thin-walled, fluid-filled benign structure in the breast.

Ductal carcinoma

—A type of cancer that accounts for as much as 80% of breast cancers. These tumors feel bigger than they look on ultrasound or mammogram.

Fibroadenoma

—A benign breast growth made up of fibrous tissue. It is the most common mass in women under 35 years of age, and is found in both breasts in 3% of cases.

Infiltrating lobular carcinoma

—A type of cancer that accounts for 8% to 10% of breast cancers. In breasts that are especially dense, ultrasound can be useful in identifying these masses.

Microcalcifications

—Tiny flecks that are too small to be felt. They are important markers of cancer that show up on ultrasound and mammogram.

Mucinous (colloid) carcinoma

—A type of cancer that accounts for 1% to 2% of breast cancers. Resembles medullary carcinoma in ultrasound and mammogram, but usually affects older women.

Nonpalpable

—Cannot be felt by hand. In cancer, growths that are nonpalpable are too small to be felt, but may be seen on ultrasound or mammogram.

Papillary carcinoma

—A type of breast cancer that primarily occurs in older women. On ultrasound, this type of tumor may look like a solid or complex mass, or it may show up as solid tissue protruding into a cyst.

Tubular carcinoma

—A type of cancer that accounts for approximately 1% to 2% of breast cancers. Can appear small on ultrasound or mammogram.

QUESTIONS TO ASK THE DOCTOR

• Why is/was this procedure necessary?
• How long will the ultrasound take?
• What are the chances of finding an abnormal growth?
• Will the results be given during the procedure?
• If an abnormal growth is found, what is the next step?