Norm of Breast Ultrasonography (Breast Echogram, Breast Ultrasound)
Normal breast tissue boundaries demonstrate bright echo reflections. The nipple and skin reflections are higher than the areola echo reflection. Fat demonstrates low reflectivity, with a mixture of low and strong echoes, whereas connective tissue and ligaments are bright. Tumors and cysts are absent. The breasts of young women have less fatty tissue than the breasts of older women.
Usage of Breast Ultrasonography (Breast Echogram, Breast Ultrasound)
Detection of tiny breast tumors, differentiation of breast cysts from breast tumors less than ¼ inch in diameter; screening for breast abnormalities in low-risk clients or where mammography is not readily available; helpful for clients with radiographically dense breasts or breast prostheses or with extensive nodal involvement; and evaluation of symptomatic clients with breast inflammation or who are pregnant or lactating.
Description of Breast Ultrasonography (Breast Echogram, Breast Ultrasound)
A noninvasive test, with a sensitivity of 98.3% and specificity of 91.7%, in which a picture of breast tissue is produced on a screen by the beaming of high-frequency sound waves into the breast and the computer processing of the signals received back through a transducer. The time required for the ultrasonic beam to be reflected back to the transducer from differing densities of tissue is converted by a computer to an electrical impulse displayed on an oscilloscopic screen to create a three-dimensional picture of the breast. An advantage of this test is that it can display all breast tissue, whereas radiography cannot. In clients with fibrocystic breast disease, the water-path method of ultrasonography may be used.
Professional Considerations of Breast Ultrasonography (Breast Echogram, Breast Ultrasound)
Consent form NOT required.
- Obtain ultrasonic gel or paste.
- The client is positioned supine and obliquely and rolled 35 degrees toward the side of the breast that will be examined. A sponge, blanket roll, or folded towel may be used to support the shoulders and hips. The client's arm on the same side to be examined should be placed behind the head.
- A greasy, conductive paste is applied to the 5.0- or 7.5-MHz, small-diameter, high-frequency transducer.
- The transducer is passed methodically over all the skin of the breast. Any known breast mass is identified, and the surrounding area in a 3-cm square is marked on the breast. The breast and marked area are scanned transversely from the inferior margin toward the head in small intervals, followed by sagittal scans moving medially to laterally. Scanning is performed with light pressure.
- Photographs are taken of the oscilloscopic display.
- Dedicated water-path breast instrumentation:
- a. The client is positioned either prone on a special bed, with the breast suspended over and into water, or supine with a bag of water overlying the breast.
- b. Scanning is performed in 1- to 2-mm intervals through the water path with a transducer. Any lesions are identified in two axes.
- Cleanse the skin of the ultrasonic paste.
Client and Family Teaching
- Wear a two-piece outfit to facilitate breast exposure for exam (if the test is performed on an outpatient basis).
- Some facilities request that no deodorants, powders, or perfumes be worn the day of the test.
- The procedure will take approximately 30 minutes.
- A breast ultrasonogram may improve the accuracy of the diagnosis when used as an adjunct to mammography.
- Results are normally available in 1–2 days.
Factors That Affect Results
- Compression of the breast may be used to eliminate nipple shadows, enable the use of high-frequency transducers, and improve delineation of the tissue. However, compression causes a misrepresentation of the breast anatomy.
- Negative ultrasonographic results should not be used to conclude a lesion is benign.
- Ultrasonography of the breast should not be used as a screening method for breast cancer because of its high rates of false-positive and false-negative outcomes.