Breast ultrasound

What it is

Breast ultrasound uses high-frequency sound waves to create images of breast tissue. It uses no ionizing radiation, so it is safe even during pregnancy and breastfeeding.

It is particularly useful for telling a cyst (a fluid-filled sac, usually benign) from a solid mass, which may need further assessment.

Why it is done

• a lump or firm area that you or your doctor can feel
• clarifying a finding on a mammogram
• localized pain, nipple discharge or other changes
• the first exam for a mass in young women (usually under 30–40 years), during pregnancy or breastfeeding
• guiding a needle biopsy
• as a complementary exam in some women with very dense tissue or high risk, at the doctor's discretion

Preparation

No special preparation is needed. It is advisable to:

• wear a two-piece outfit, so that only the top needs to be removed
• not apply cream, powder or deodorant to the chest and armpit
• bring previous mammograms and ultrasounds for comparison

How it is performed

You lie on your back with your arm above your head. The doctor applies gel to the skin and moves the probe over the breast and armpit (for the lymph nodes). The exam is painless and usually takes 15–30 minutes.

What it shows — and what it does not

The report describes the findings and often classifies them using the BI-RADS system, which indicates the level of suspicion and the next step (follow-up, a re-check after a few months, or a biopsy).

• The ultrasound appearance does not always replace the histological diagnosis — when there is suspicion, a biopsy gives the definitive answer.
• A normal result does not close the assessment of a suspicious clinical change.

Ultrasound and screening

Ultrasound does not replace screening mammography and is not recommended as a routine annual check for every young woman without symptoms.

The starting age and interval for mammography vary according to national programs — for example, the NHS program in England invites women from 50 to 71 years of age. This is not necessarily the rule in Albania; talk to your doctor about the plan that suits you. Women at high familial or genetic risk need a separate plan, which may include magnetic resonance imaging.

When to seek a consultation without waiting

• a new lump in the breast or armpit
• a change in the shape or size of the breast
• nipple retraction
• spontaneous bloody nipple discharge
• skin changes (redness, "orange-peel skin") that do not go away