Breast ultrasound

The breast ultrasound is the ultrasound examination of the breast. It involves an imaging method in which the breast is shown in a cross-sectional imaging. The breast ultrasound as mammography in a apparative method for screening and diagnosis of benign and malignant breast tissue changes.

Areas of application

Recognized is the primary use of sonography in women less than 40 years. Secured is also the complementary use of unclear mammographic findings, as well as at high mammographic density. Breast ultrasound is also indicated in women and men with a palpable mass or pain in the chest and at discharge from the nipple. Under ultrasound and fine-needle biopsies and punch biopsies are performed to selectively remove tissue samples for histological examination.

Primary screening

Like the other methods, the breast ultrasound for early detection of breast cancer can be used. Advantages over mammography has sonography in women at high glands Share ( high density ), so that even in pre-menopausal women. Even in women during pregnancy and lactation breast ultrasound should be used as the first imaging technique since it does not involve radiation exposure and is straightforward to use after palpation.

The dispute on the screening mitt breast ultrasound as screening test comparable to mammography screening. This lack of large randomized or prospective studies and problems of quality assurance are criticized. On the other hand, are increasingly faced with non-randomized studies with very encouraging results. In principle, no single imaging examination method of breast can discover each breast cancer. The sensitivity of ultrasonography is likely to be higher for the ( invasive ) cancer than mammography. Precursors of invasive cancer (DCIS ), insofar as these are characterized by the formation of microcalcifications, are better detected by mammography.

Secondary screening

In addition to mammography, an ultrasound is used especially at high breast density.

Differentiation

The diagnostic differentiation by sonography is today beyond the differentiation of cystic from solid findings by the solid lesions into benign, probably benign, suspicious and hochsuspekte different ( BI-RADS classification). Here ( echogenicity ) are particularly adjacent to the internal echo pattern, the edge structures of a lesion of relevance.

Technology

The breast ultrasound today turns to high-definition broadband linear probes with a frequency between 2-17 MHz. For B-scan additional technical developments for the purpose of differentiation between benignity and malignancy adjust color Doppler sonography showing the vascular supply, the 3D ultrasound with its additional supervisory level (C- level) and elastography with the color coding of the tissue stiffness dar.