Breast ultrasound – how to interpret the results?

Breast ultrasound is a quick and painless examination to visualize the breast tissue. Its result influences further diagnostic and therapeutic procedures. Unfortunately, many patients do not fully understand their results and do not know what to do next. If you are one of them, then this article is for you.

The aim of the article is to explain the most common terms used in breast ultrasound descriptions. It should be remembered that the correct analysis will only be carried out by a doctor, therefore any doubts should be discussed with him.

Breast ultrasound – indications

Before you familiarize yourself with the discussion of the terms used in the description of ultrasound, it would be good for you to recall the main indications for the examination. The most important of them are:

  1. prophylactic examination in women under 40,
  2. palpable lumps or lumps in the breast
  3. follow-up examination after mammography,
  4. differentiation of the nature of the change,
  5. diagnostics of breast changes in breastfeeding women (diagnostics using X-rays is contraindicated in pregnant and lactating women),
  6. leakage from the breast
  7. injuries.

Check the preparation and course of the breast ultrasound examination

Selected terms used in the description of breast ultrasound

The terms used in the description of breast ultrasound do not differ much from those used in the description of mammography. However, there are some differences worth knowing.

  1. Macrocalcifications in breast ultrasound

What they mean: these are clusters of calcium deposits that build up in the mammary glands.

Interpretation: Macrocalcifications are generally indicative of a benign lesion such as fibroadenoma, in contrast to microcalcifications found on mammography, which may indicate a malignant lesion.

Find out more about breast fibroadenomas

  1. Cyst in breast ultrasound

Which means: most often it means a mild lesion, it may indicate that there is a well-defined reservoir in the breast that contains fluid or air.

Check the causes of the appearance of a cyst in the breast

  1. Glandular-fibrous weaving in breast ultrasound

Which means: maybe it means that connective and glandular tissue predominate in the breast.

Interpretation: such a result does not cause oncological concern, it is a physiological state.

  1. Glandular-adipose tissue in breast ultrasound

Which means: maybe it means that the weaving of the breasts is dominated by adipose tissue and glandular tissue

Interpretation: it most often appears in elderly women and is a physiological condition.

  1. Focal change in breast ultrasound

What it means: a single change detected in the examination, it may be a solid tumor or a cyst, among others.

Interpretation: is a very general statement, it may indicate a malignant as well as a benign lesion.

Read more about benign breast disease

  1. Increased vascularization in breast ultrasound

Which means: in the case of breast tumors, it indicates that there is an increased number of blood vessels within the tumor.

Interpretation: may indicate a malignant nature of the lesion.

  1. Widened milk ducts in breast ultrasound

Interpretation: The milk ducts may widen as a result of retention of fluid content or the presence of tissue structures such as intraductal papillomas.

  1. Hypoechoic change in breast ultrasound

Which means: on ultrasound imaging, the lesion is darker than the surrounding area.

Interpretation: hypoechoic lesions are soft lesions with increased blood supply, for example solid tumors, which may be benign or malignant.

  1. Hyperechoic change in breast ultrasound

Which means: on ultrasound imaging, the lesion is brighter than the surrounding area.

Interpretation: These are hard and dense lesions, like bones or calcifications, but also gases.

  1. Reactive lymph nodes in breast ultrasound

What they mean: lymph nodes enlarged due to an ongoing inflammatory process in or around the nodes themselves.

Interpretation: The most common cause of reactive lymph nodes is infection.

What does lymphadenopathy show?

  1. Indistinctly demarcated edges of the breast ultrasound lesion

What they mean and interpretation: they can be specular, obliterated and angular. Contrary to clearly delimited edges of lesions, they more often indicate a malignant lesion.

BI-RADS classification system in breast ultrasound

As in the case of mammography, the description of breast ultrasound should be used the BI-RADS rock, in which we can distinguish:

  1. BI-RADS 0 – indicates the order of implementation of further diagnostics, as it does not provide sufficient data for diagnosis.
  2. BI-RADS 1 – indicates correct result, periodic inspection is recommended.
  3. BI-RADS 2 – indicates a normal result and the appearance of benign changes, such as cysts or fibroadenomas.
  4. BI-RADS 3 – indicates the appearance of a benign lesion, but the risk of its malignancy is 2%. With such a result, re-diagnosis is recommended after 6 months. If the patient is at risk of breast cancer, additionally a chub-needle biopsy with histopathological examination is performed.
  5. BI-RADS 4 – indicates the presence of a lesion that requires core-needle biopsy. BI-RADS 4 is divided into three subcategories which indicate different risk of malignancy of the lesion

– 4a – in which the risk of malignancy of the lesion ranges from 2% to 10%,

– 4b – in which the risk of malignancy of the lesion ranges from 10% to 50%,

– 4c – in which the risk of malignancy of the lesion ranges from 50% to 95%.

  1. BI-RADS 5 – means a lesion with a malignancy risk greater than 95%. In such cases, additional diagnostics in the form of core-needle biopsy should be performed as soon as possible.
  2. BI-RADS 6 – indicates the presence of breast cancer (histopathological diagnosis).

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