Ultrasound of the breast

Synonyms in a broader sense

Ultrasound examination, sonography, sonography

Ultrasound as a preventive examination

The ultrasound scan of the breast (Breast sonography) is an important examination method which, in addition to palpation examinations and mammography screening, is primarily used to detect breast cancer.

The great advantage of an ultrasound examination of the breast is that this method (in contrast to mammography, which works with X-rays, for example) works without any radiation exposure and is therefore not associated with any risk for a patient.

In order to examine the breast with the aid of ultrasound, a so-called contact gel must be applied to the skin. The ultrasound probe is then placed on this gel, with which the doctor moves over the skin and thus receives images of the inside of the breast, which are displayed on a screen on the ultrasound device.

Please also read our page about Breast cancer screening.

Reasons for an ultrasound

There are several reasons why an ultrasound scan is recommended. The most common reason why an ultrasound is done is an unclear palpable finding. This means that a patient or the gynecologist will notice a hardening or compression within the breast during a preventive examination, which is suspicious of a tumor in the breast (breast cancer, Breast cancer) is. Other changes in the breast (for example, pain, reddening of the skin, leakage of fluid from the nipple, bulging, retraction, or other changes to the surface of the skin of the breast or nipple) or an unclear finding on the mammogram may also be the reason for an ultrasound to order to rule out breast cancer. These symptoms can also occur in men and be an indication of breast cancer in men, which is why an ultrasound examination should also be performed here.

With the help of ultrasound waves, a two-dimensional image is created in the usual display form (the 2D real-time mode), on which the different tissues have different levels of brightness due to different densities. While structures that strongly reflect the waves, such as bones or lime, appear almost white on the ultrasound image, objects filled with liquids are darker to black. This makes it easy to distinguish nodules from cysts with the help of an ultrasound scan.
Cysts are (in contrast to lumps, which actually consist of mammary gland tissue) are cavities that are filled with fluid and are usually harmless findings. However, when palpating the chest, in some cases these can feel lumpy. With the ultrasound, the patient can often be spared a biopsy, which would otherwise be used to conduct a more detailed examination of suspicious nodular structures. Lime, on the other hand, cannot be represented particularly well by ultrasound. Since this can be an indication of a preliminary stage or an already existing breast cancer, it is important to recognize calcium deposits in the breast in good time.Therefore, ultrasound is not suitable as the only early detection method for cancer, but must always be used in combination with mammography (and palpation). Lymph nodes, which can be enlarged in the context of breast cancer or simple infections, can usually be shown well with the ultrasound.

In younger women in particular, the glandular tissue of the breast is in most cases so dense that mammography does not provide any meaningful findings and sonography is therefore the method of choice for assessing the structure of the breast.

Please also read our page Recognize breast cancer or Ultrasound in physical therapy

costs

If abnormalities in the breast are detected during the ultrasound, a special form of the ultrasound examination, the so-called Doppler sonography, can follow. During this examination, the blood flow to the breast can be assessed: Since a tumor, like any other tissue, needs blood vessels to supply it with the necessary nutrients, the display of the blood flow in a suspicious area can provide information on the possible presence of a malignant degeneration.

Read more on the topic: Doppler sonography

If the ultrasound examination of the breast is initiated by the doctor due to a medical necessity (such as an unclear palpable finding or to monitor the progress of a therapy), the statutory health insurance companies will cover the costs of this measure. However, if patients want such an examination even without one of the above-mentioned findings, they can pay them themselves for an amount between 35 and 75 euros.