Breast ultrasound is a diagnostic procedure during which the structure of breast tissues is displayed on the monitor using ultrasound waves. The study is informative in the diagnosis of inflammatory processes of the breast, cysts, mastopathy, benign and malignant tumors. Sonography is performed in two-dimensional mode, as well as in the mode of energy and color mapping. Mammary glands are examined in isolation or in combination with ultrasound of lymph nodes, Doppler ultrasound of blood vessels.
It is not necessary to carry out preparatory measures before the breast ultrasound procedure. In the absence of acute symptoms – pain, bleeding – the examination is recommended to take place on the 5-10 day of the menstrual cycle.
Breast ultrasound displays the structure of glandular tissue – the nature of echogenicity, the presence of hyperechogenic and hypoechoic foci, diffuse density change. In the study of the lymphatic system, the sizes of axillary, supraclavicular, subclavian, anterior thoracic and posterior lymph nodes are estimated. Dopplerography allows you to determine the anatomy of the blood vessels of the gland and the speed of blood flow, to identify areas of increased blood supply.
Normally, a uniform echogenic structure of the skin is displayed, in the gland – hyperechogenicity of connective tissue and parenchyma, low echogenicity of fat lobules penetrated by lines of moderate echolithiness. In patients under 30 years of age, the mammary glands consist mainly of glandular tissue, there are no dilated ducts; from 40 to 50 years of age, glandular tissue and a moderate amount of connective tissue are visualized, the ducts are not dilated; after 50-55 years, glandular cells are replaced by fatty, connective tissue elements are depleted. Ultrasound examination of the breast allows you to diagnose:
- Inflammatory diseases. Common inflammatory diseases of the mammary glands include mastitis, abscesses, infiltrates. Typical ultrasound signs: smoothed display of differentiated structures, enlarged milk ducts, thickening of subcutaneous tissue and skin, increased blood flow. Infiltrates are visualized as hypoechoic zones with clear contours.
- Mastopathy. Common signs of diffuse fibrocystic mastopathy are thickening of glandular tissue, fibrosis of the interlobular septa and duct walls, multiple cysts (anechoic foci), expansion of the milk ducts, mismatch of the tissue structure to the patient’s age. In the nodular form of the disease, foci of high echogenicity with fuzzy contours are detected.
- Fibroadenoma. This type of tumor refers to benign. Ultrasound reveals the formation of a rounded, oval or lobed shape, homogeneous, hypoechoic, with a thin echogenic rim, a pronounced ultrasonic shadow. Pericanacular fibroadenoma has clear and even contours, intracanacular and mixed neoplasms – blurred and uneven contours, heterogeneous hypoechoicity.
- Breast cancer. Specific ultrasound criteria for malignant neoplasms are an uneven contour, vertical orientation, heterogeneity of the internal structure, the predominant solid component. Convoluted intranodular vascular loci are determined by color and energy mapping.
The ultrasound picture is interpreted together with the results of anamnesis, clinical examination, examination, mammography (radiography of the mammary glands). If a malignant process is suspected, a biopsy of the gland is prescribed with a cytological examination of the tissue material.
Ultrasound of the breast has a high resolution, which reveals pathological processes that are not radiologically displayed. The procedure has no contraindications, has no effect on the body, can be used for examination of pregnant and elderly women. The disadvantage of the method is the low information content in fat involution, the inability to visualize the organ as a whole. Breast ultrasound is cheaper than X-ray techniques (mammography, ductography, CT), MRI, but at the same time it is inferior in information content to methods conducted with contrast enhancement.