Presentation on theme: "The role of ultrasound in breast imaging Dr Francien Malan Drs Van Wageningen & Vennote 31 October 2007."— Presentation transcript:
The role of ultrasound in breast imaging Dr Francien Malan Drs Van Wageningen & Vennote 31 October 2007
How does ultrasound work? High frequency sound wave Crystal probe serves as both transmitter and detector of sound waves Different tissue types Signal coming back translated into real time black and white picture by computer software
Palpable masses Mammographically detected masses Dense breasts Young patients Pregnant/ lactating woman Breast implants Guided aspiration/ biopsy/ localisation Uses of ultrasound in breast imaging
Palpable abnormality Ultrasound especially useful if mammogram shows no obvious abnormality +/- mammo shows abnormality Young patients Benefits of ultrasound
Cystic or solid?
Simple cyst Typical fibroadenoma
Dense/white breasts Fatty/ dark breasts
Dense breasts means a relatively large percentage of fibroglandular tissue and little fat 50% of patients <30yrs 1/3 of patients > 50yrs Can’t “see through” Ultrasound useful!!!
Young patients (<30/ <35yrs) Should be first investigation; mammogram only if ultrasound equivocal Palpable lesions in young woman most commonly cysts or fibroadenomas
Most common problem in lactating woman is mastitis +/ breast abcesses + US guided drainage of abcess
Indications the same as for women without implants Also for evaluation of implant complications such as rupture
Ultrasound guided cyst aspiration/ biopsy Aspiration of cysts are done when cyst has atypical features, pain relief, relief of anxiety, cosmetic reasons Biopsy done when after clinical evaluation/ mammography and ultrasound the nature of lesion is still uncertain
What happens? Outpatient Sterilised, anaethetised Needle is guided into cyst under direct ultrasound vision Cells obtained to path lab for evaluation
Ultrasound guided localisation Localisation is done prior to surgical resection of lesion to guide surgeon to the lesion, can be done with u/s or mammogram Inpatient, fasting, sterile conditions, local anaesthetic, localisation needle guided into lesion, wire strapped to arm, patient goes to theatre.
Lesion visible on ultrasound, not clinically palpable; may or may not be visible on mammogram Benefits of real time guidance of wire into lesion; 3D perspective; relatively quick; Why ultrasound for localisation?
Why mammogram for localisation? Microcalcifications Small lesion deeply seated in large breasts Area of suspicion on mammogram not visible on ultrasound