Breast ultrasound is a non-invasive imaging technique that primarily uses high-frequency sound waves to generate tissue images for evaluating abnormal breast lesions. This examination carries no risk of ionizing radiation exposure, making it especially suitable for young women or patients with dense breast tissue. It effectively differentiates benign from malignant tumors.
The main clinical applications include initial screening for breast tumors, diagnosis of cysts and fibroadenomas, and guidance for needle biopsies. The procedure is painless, quick, and typically completed within 15-30 minutes, with results immediately interpreted by a radiologist.
Breast ultrasound is divided into "real-time imaging" and "3D imaging". Real-time imaging involves moving the probe on the skin to produce live images, while 3D imaging constructs a three-dimensional model to accurately measure the size and shape of lesions. Sound waves reflect at tissue interfaces, creating images with contrast based on tissue density differences.
The mechanism involves sound waves penetrating breast tissue, with sensors receiving reflected signals, which are then converted into two-dimensional or three-dimensional images by a computer. This technology effectively displays differences between fluid accumulations (such as cysts) and solid tumors, and has unique advantages in dynamic blood flow observation.
Main indications include:
It is also commonly used as an adjunct in breast cancer screening, especially in women under 35 or those with dense breast tissue, where its sensitivity exceeds that of mammography.
During the exam, patients are required to remove their upper garments and wear a gown. Medical staff will apply gel to the skin and move the probe to scan. No contrast agents or special preparations are needed. The sound wave frequency and intensity are regulated, typically using probes with a frequency of 7-12 MHz.
The procedure includes multi-angle scanning and dynamic imaging, with ultrasound-guided biopsies performed if necessary. Immediate preliminary reports are available post-examination, while complex cases may require detailed analysis by a radiologist.
Main advantages include:
Additionally, the cost is more economical compared to MRI, with no fasting or special preparations required. Results can be immediately cross-referenced with other imaging modalities such as mammography.
This examination has no biological side effects, but the operation process may cause:
Important Notice: A negative result does not entirely exclude pathology; clinical symptoms and other test results should be comprehensively evaluated.
Contraindications include:
Special considerations include cleaning the breast surface before the exam, informing medical staff if pregnant, and avoiding unnecessary abdominal scans.
This examination does not directly interact with chemotherapy or hormone therapy but may influence the timing of other imaging assessments. For example, tumor shrinkage post-chemotherapy may affect ultrasound baseline images.
It is often combined with mammography for "dual screening". When results are inconsistent, further MRI or fine-needle aspiration may be necessary.
According to the American College of Radiology, breast ultrasound has an accuracy rate of up to 95% in differentiating cysts and a sensitivity of 85% for tumors smaller than 1cm. Multiple studies show that combined use with mammography can improve early breast cancer detection rates by 15-20%.
Clinical guidelines recommend ultrasound as the primary imaging modality for women under 30, with combined mammography for those over 40. Dynamic blood flow analysis has been validated by several prospective studies for accurate staging of breast cancer.
Alternative methods include:
When choosing alternatives, factors such as patient age, medical history, and economic considerations should be taken into account. For example, patients with dense breasts may require MRI, and high-risk groups might need genetic testing and regular follow-up.
What preparations are needed before the examination?
It is recommended to wear an open-front top to facilitate exposure of the examination area and avoid wearing one-piece clothing. If the patient has had breast surgery or implants, inform the medical staff in advance. No fasting or special diet restrictions are necessary on the day of the exam; keep the breasts clean and dry.
Does the patient's position during the exam affect accuracy?
Doctors will adjust the patient's position based on the lesion location, possibly requiring side-lying or arm elevation to obtain optimal images. Specific positions can reduce tissue overlap shadows and help assess tumor shape and margins more accurately. Follow medical staff instructions to move the body accordingly.
What should I do if I experience breast tenderness after the exam?
The ultrasound itself is non-invasive, but prolonged pressure may cause temporary discomfort. Applying ice within 24 hours after the exam can help alleviate pain. If pain persists beyond 48 hours or is accompanied by redness or swelling, seek medical attention to evaluate for other complications.
Can patients with pacemakers or other electronic implants undergo the exam?
Ultrasound uses sound waves and does not interfere with electronic medical devices. Patients with pacemakers or spinal stimulators can safely undergo the procedure. However, inform the staff of the implant location so they can adjust the scanning angle to avoid direct contact with the device.
How soon should follow-up exams be scheduled if abnormalities are found?
If benign tumors like fibroadenomas are detected, follow-up is typically recommended every 6-12 months. Suspicious malignant lesions may require re-examination within 1-3 months to monitor changes. The specific frequency should be individualized based on tumor size, margin regularity, and patient risk factors, as determined by the physician.
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