Sonographic Evaluation of the Breast

reast ultrasound has become the most useful and widely available adjunctive breast imaging evaluation and guidance modality for percutaneous breast biopsy and preoperative localization. Mammography remains the gold standard screening examination , recommended yearly for all women over 40, regardless of risk assessment. Despite the proven benefits of mammogra-phy, however, there are limitations in areas of the breast where the tissue is dense or where focal changes in breast architecture appear when compared with previous mammo-grams. In these cases, targeted breast ultra-sound can increase diagnostic accuracy. In cases of palpable lumps, breast ultrasound is always recommended. Criteria have been established to distinguish benign from malignant characteristics in palpable and nonpalpable breast masses. The Breast Imaging Reporting and Data System for ultrasound, BI-RADS, has been instituted to standardize the criteria for interpretation and reporting. 1 These developments , along with advances in instrumenta-tion, have made the role for breast ultra-sound more important and necessary in the breast imaging evaluation. Its use allows more thorough and immediate evaluation of suspected breast abnormalities, which can speed diagnosis. Ideally, mammographic and sonographic workup, as well as ultrasound-guided biopsy, can occur within a single patient visit. Most important, the use of ultrasound in the evaluation of suspected clinical and mammo-graphic abnormalities can reduce the false-positive rate by demonstrating benign characteristics , thus increasing the specificity of the imaging evaluation and reducing the rate of biopsies for benign lesions. The utility of whole-breast bilateral screening ultrasound is currently under investigation. Several studies have already shown that ultrasound can demonstrate small, nonpalpable, invasive cancers that are not seen on mammography. 5-7 Ultrasound is less sensitive, however, than mammography or MRI in the detection of ductal carcinoma in situ. 2-4 As technology continues to improve and the common practice of breast ul-trasound increases, the diagnostic capabilities of breast ultrasound will expand. • Determine the indications for breast ultrasound. • Identify structures demonstrated in sonographic evaluation of the normal breast. • Detect abnormal structures demonstrated in sonographic evaluation of the breast. • Distinguish benign and malignant characteristics of breast masses. interested in body imaging will benefit from the information in this educational activity and can receive Continuing Medical Education credit by completing the post-test and evaluation provided. Dr. Wilkes has no significant financial arrangement or affliation with any manufacturer of any pharmaceutical or medical device and is not affiliated in any manner with any provider of any commercial medical …