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Questions and Answers
What is the recommended frequency range for a hand-held, direct contact transducer used in breast ultrasound?
Historically, what ultrasonic method was used to examine the breast with ultrasound in the early eighties?
What is the current consensus on using ultrasound as a screening tool for breast cancer?
What organization recognizes breast ultrasound as a separate specialty with a separate registry examination?
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What is the recommended range of frequency for the high frequency hand-held, direct contact transducer used in breast ultrasound?
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What is the primary focus of this module on the use of diagnostic ultrasound in the examination of the breast?
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What is NOT recommended as one of the clinical indications for breast ultrasound?
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Which type of breast lesions often show some degree of enhancement on sonography?
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What is a common feature of most breast carcinomas on sonography?
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What is a characteristic feature of fibroadenomas on sonography?
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What is a distinguishing feature of breast carcinomas compared to benign lesions on sonography?
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What feature is characteristic of a desmosplastic reaction around breast carcinomas?
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What is a typical shape of fibroadenomas on sonography?
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What is a common characteristic of most breast carcinomas on sonography?
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What feature is often seen around breast carcinomas on sonography?
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What is a distinguishing feature of fibroadenomas compared to carcinomas on sonography?
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What is the typical size range of normal mammary ducts in high resolution ultrasound?
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What is the appearance of fibroadenomas on ultrasound?
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What is the most common appearance of galactoceles on ultrasound?
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What is the role of ultrasound in determining breast masses?
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What is the role of Cooper’s ligaments in breast ultrasound?
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What is the typical appearance of the pectoralis major muscle on breast ultrasound?
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What are the limitations of ultrasound in detecting certain breast carcinomas?
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Which type of ultrasound removes operator variability and produces consistent 3D data sets for objective review?
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What is the primary purpose of using ABUS?
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What is the main advantage of hand-held breast ultrasound over ABUS?
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What can help distinguish hypoechoic solid masses from cysts in hand-held breast ultrasound?
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What can be technically difficult to image in hand-held breast ultrasound?
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What allows for more accurate referencing of breast lesions on high-end ultrasound systems?
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What determines the ultrasound appearance of the normal breast?
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What is a distinguishing feature of fibroadenomas compared to carcinomas on sonography?
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What is the primary purpose of using ABUS?
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What organization recognizes breast ultrasound as a separate specialty with a separate registry examination?
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What is the role of Cooper’s ligaments in breast ultrasound?
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What is the recommended range of frequency for the high frequency hand-held, direct contact transducer used in breast ultrasound?
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What allows for more accurate referencing of breast lesions on high-end ultrasound systems?
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What is a common characteristic of most breast carcinomas on sonography?
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What is the primary advantage of Automated Breast Ultrasound Systems (ABUS) over hand-held breast ultrasound?
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What is the recommended reference for imaging in hand-held breast ultrasound?
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What is the role of Doppler in hand-held breast ultrasound?
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What feature can be technically difficult to image in hand-held breast ultrasound?
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What allows for more accurate referencing of breast lesions in high-end ultrasound systems?
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What is the primary focus of Automated Breast Ultrasound Systems (ABUS)?
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What is the typical ultrasound appearance of the normal breast dependent on?
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Study Notes
Breast Ultrasound Imaging: Key Points
- Normal mammary ducts are frequently seen in high resolution ultrasound, with typical ducts ranging in size from 1 - 8 mm.
- Many cancers arise within the ducts, including ductal carcinoma in situ (DCIS) and invasive ductal carcinoma.
- Cooper’s ligaments, also known as suspensory ligaments, provide the supporting framework for the breast and can generate refractive edge shadowing when caught obliquely by the ultrasound beam.
- The pectoralis major muscle is an important landmark in breast ultrasound, appearing as a hypoechoic striated layer against the chest wall.
- Ribs appear as oval hypoechoic structures behind the pectoralis major muscle and produce strong acoustic shadowing.
- Small blood vessels may be seen in the region of the axilla, and lymph nodes are most commonly seen in the axilla with an appearance similar to cervical lymph nodes.
- Ultrasound is considered an adjunct to mammography and the physical exam, and is most useful in various clinical settings such as determining if a mass is cystic, solid, or complex, and localizing a mass for biopsy or FNA.
- Ultrasound has limitations in detecting certain breast carcinomas, particularly those less than 1 cm in size, and has difficulty in differentiating benign and malignant masses.
- The most common breast masses are cysts, fibroadenomas, and carcinomas, and ultrasound is able to determine if a mass is solid, cystic, or complex, but is unable to reliably differentiate benign and malignant masses.
- Breast cysts can occur at any age, with a sonographic diagnosis based on specific criteria, and a complicated cyst may require cyst aspiration to ensure it is benign.
- Galactoceles are retention cysts caused by lactiferous duct obstruction, manifesting as painless breast lumps, and typically appear as well-defined complex cystic masses on ultrasound.
- Fibroadenomas are common, benign tumors occurring most frequently in younger females, and appear as well-marginated solid masses with uniform low-level internal echoes on ultrasound.
Automated Breast Ultrasound Systems (ABUS) and Hand-Held Technique
- Automated Breast Ultrasound Systems (ABUS) are available from various vendors such as Siemens and GE
- ABUS uses a large scanhead with a linear array transducer and scanning membrane, attached to an articulated arm
- ABUS removes operator variability and produces consistent 3D data sets for objective review
- ABUS is frequently used to assess or screen patients with dense breasts, as ultrasound can be better at examining dense breasts than mammography
- Hand-held breast ultrasound uses a high frequency 5 - 10 MHz linear array transducer
- Hand-held technique involves scanning the breast in an organized fashion, using the nipple as a reference
- Doppler can help distinguish hypoechoic solid masses from cysts in hand-held breast ultrasound
- The nipple/areolar area can be technically difficult to image in hand-held breast ultrasound
- Reference should be made to the patient’s mammographic films in hand-held breast ultrasound
- An extended field of view option on high-end ultrasound systems allows for more accurate referencing of breast lesions
- The breast consists of lobes of glandular tissue, fatty tissue, and a framework of fibrous tissue, nerves, and blood vessels
- The ultrasound appearance of the normal breast depends on the internal architecture, and the bulk of the breast lymphatics drain into the axillary nodes
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Description
Test your knowledge of Automated Breast Ultrasound Systems (ABUS) and Hand-Held Breast Ultrasound techniques with this quiz. Explore the technology, applications, and best practices for conducting ultrasound examinations of the breast, including the use of Doppler and referencing mammographic films.
