BREAST CANCER ULTRASOUND: UNDERSTANDING ITS ROLE IN DETECTION

What is a Breast Cancer Ultrasound?

A breast cancer ultrasound is a non-invasive imaging procedure that uses high-frequency sound waves to create detailed images of the breast tissue. It plays a critical role in breast cancer detection, particularly for those with dense breast tissue or other risk factors, by providing additional information beyond what mammograms can offer.

Unlike mammography, which uses X-rays, ultrasound is often used as a complementary tool to investigate further suspicious areas detected by mammography. There is no radiation associated with ultrasound, compared to the very small amount of radiation used in mammography.

Routine breast cancer screening usually involves a mammogram initially as this has the best evidence in that setting. This may then lead to an ultrasound in certain circumstances. Screening is vital for early detection, especially for those with a family history of breast cancer or other risk factors. Early detection greatly improves the chances of successful treatment.

Can an Ultrasound Detect Breast Cancer?

Ultrasound breast cancer imaging is highly effective in distinguishing between solid masses and fluid-filled cysts, but it is not always able to detect early-stage cancers or microcalcifications visible on mammograms.

Breast cancer on ultrasound images is typically identified by observing abnormalities in tissue. The imaging method is typically used in combination with mammography or other diagnostic tools to confirm findings. It is especially valuable in women with dense breast tissue or when investigating lumps.

Ultrasound cannot definitively diagnose cancer but can provide essential clues about a lump’s characteristics, such as whether it is solid or cystic. A biopsy is typically required to confirm the final diagnosis. 

Ultrasound can also be used to detect whether there are abnormal lymph nodes under the arm in patients with a confirmed breast cancer diagnosis. Whilst this is also not definitive, it assists in determining the cancer stage and subsequent treatment strategies.

How Does Ultrasound Detect Breast Cancer?

Ultrasound is instrumental in assessing abnormalities in breast tissue. It allows doctors to evaluate the nature of suspicious areas by providing detailed imaging of masses and cysts.

With a breast ultrasound, cancer can be distinguished between benign fluid-filled cysts and solid masses. It provides insights into the size, shape, and texture of potential abnormalities, helping doctors determine the need for further testing.

Another benefit is that ultrasound breast cancer on ultrasound scans can effectively rule out cancer by providing an alternative diagnosis, without the need to go to biopsy.

What does breast cancer look like on an ultrasound?

Using sound waves, an ultrasound can reveal tumours or lumps that are otherwise difficult to identify with mammograms, especially in denser breast tissue. Breast cancer on ultrasound may appear as irregularly shaped masses or areas with uneven borders on an ultrasound. These characteristics often stand out compared to benign conditions. 

Types of Breast Ultrasound and Their Role in Breast Cancer Diagnosis

Different types of ultrasounds are used in breast cancer diagnosis, each serving a specific purpose.

• Diagnostic ultrasound: Used to investigate suspicious findings from a clinical exam or mammogram.
• Ultrasound-guided biopsy: Helps in extracting breast tissue samples for further testing.
• 3D ultrasound: Offers enhanced imaging and accuracy.

How Ultrasound Supports Early Detection of Breast Cancer

Breast cancer ultrasound is an essential tool in the early detection of breast cancer, offering a non-invasive method to explore suspicious masses. The use of ultrasound breast cancer as a subsequent test after abnormal screening mammography, or in selected other patients, is an important component

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FAQs

What makes a breast lump suspicious on ultrasound?

On ultrasound, certain characteristics of a breast lump can raise suspicion for cancer. Radiologists evaluate these features to decide if further testing, such as a biopsy, is necessary. These can include:

• Shape: Suspicious lumps often have irregular or asymmetrical shapes, whereas benign lumps are usually round or oval.
• Margins: Cancerous lumps may have jagged or ill-defined edges, while benign lumps tend to have smooth and well-defined borders.
• Echogenicity: Cancerous lumps may appear hypoechoic (darker) compared to surrounding tissue and may display shadowing on the ultrasound.
• Growth Patterns: Cancerous lumps may invade surrounding tissues, altering their appearance on ultrasound. Benign lumps typically remain confined.
• Vascularity: Doppler ultrasound may show increased blood flow in or around a suspicious lump, indicating possible malignancy.

What percent of breast cancer is caught early?

Early detection of breast cancer is critical for successful treatment, and modern screening methods, such as mammograms and ultrasounds, have significantly improved early diagnosis rates.

Small breast cancers (≤15 mm in diameter), that have not spread to lymph nodes or elsewhere, tend to be associated with more treatment options, lower morbidity and improved survival. In 2020, 45% of breast cancers detected in participants attending their first screen, and 62% of breast cancers detected in those attending subsequent screens, were small. In comparison, just 28% of breast cancers detected outside BreastScreen Australia are small (AIHW 2018).

Early-stage cancers are localised, meaning they haven’t spread to lymph nodes or distant organs. The 5-year survival rate for early-detected (stage 1A) breast cancer is about 99%, compared to much lower rates for cancers detected at later stages. Regular mammograms, ultrasounds, and self-exams contribute significantly to catching cancer in its early stages.