What You Need to Know About Breast Ultrasound
A breast ultrasound exam is primarily performed to further evaluate the breast after a mammogram, a breast MRI (magnetic resonance imaging) or findings during a clinical exam, often to answer a specific problem or question.
We also perform breast ultrasounds to provide guidance for breast biopsies and other interventions.
In certain circumstances, when women are at high risk for developing breast cancer and/or have dense breasts, ultrasound or MRI can be used as a screening tool, in addition to mammography.
Determining what, if any, additional screening test should be performed requires a conversation between you and your doctor. Mammography is the best screening tool available to detect for breast cancer. Other screening tests should be performed in addition to mammography — without replacing it.
Additional screening tests such as breast ultrasound may not be covered by your health insurance; check with your insurance company prior to having additional screening.
Breast Ultrasound FAQs
What is an ultrasound?Ultrasonography uses sound waves, instead of radiation or X-rays, to create an image of part of the body. Our radiologists use ultrasound to further evaluate abnormalities seen on a patient’s mammogram or in an abnormal clinical breast exam.
Ultrasound can differentiate a solid mass from a cyst (small fluid-filled structures within the breast). Ultrasound is used to help differentiate benign, solid masses from any malignant (cancerous) masses. Ultrasound is a non-invasive exam, which means it is performed without cutting your skin or putting instruments inside your body.
As the transducer moves over the skin area, it sends out silent sounds waves that bounce off surfaces in the breast. Inside the transducer is a tiny, very sensitive microphone that records the changes in the sound as it bounces off the inside of the breast. The sound waves are instantly measured and displayed by a computer as a photographic image, also called a sonogram, on a screen.
What is the difference between a "whole breast" ultrasound and a "targeted" ultrasound?A targeted ultrasound looks at a specific part of the breast due to an abnormal mammogram or focal breast symptoms. A whole breast ultrasound looks at the entire breast and is performed as a supplemental screening test to mammography to look for breast cancer.
Breast imaging specialists do not routinely recommend whole breast ultrasound screening, unless the patient carries a high risk for breast cancer and for some reason cannot undergo breast MRI. When a patient has a whole breast ultrasound exam here at BIDMC, the scan is performed on the same equipment as the targeted ultrasound, in the same way by the technologist and radiologist, but on both breasts. This exam may take up to an hour.
How do I prepare for my ultrasound exam?There is no preparation for a breast ultrasound exam. You may want to wear a two-piece outfit to the exam, so you only need to take off your top. Be sure to eat what you normally eat and take whatever medications you normally take.
What should I bring to my ultrasound exam?If your breast imaging (mammogram, ultrasound, or MRI) was done in the past at one of BIDMC's breast imaging locations, then we will gather these images and reports for our team to review. You do not need to bring anything else to your ultrasound exam at our BreastCare Center.
If your breast imaging was not done at a BIDMC location, and you are receiving a second opinion or transferring your care here, you will need to send specific materials to us ahead of your ultrasound appointment at BIDMC. Contact the Radiology Film Library at the facility where you had your previous breast imaging done. Ask them for any of your breast images and reports from the past three years and arrange for them to be sent to us digitally, or via FedEx or UPS at:
Beth Israel Deaconess Medical Center
Attn: Radiology Film Archive Dept.
Shapiro Clinical Center, 4th Floor
330 Brookline Avenue
Boston, MA 02215
Please arrange for the information to be sent well in advance of your appointment, if possible. Our experts need time to review any radiology images, and other relevant medical information, to ensure an accurate diagnosis.
It’s a good idea to contact our Breast Imaging Unit several days before your appointment to confirm that we have received these images and reports. Our telephone number is 617-754-9500.
If I have already had a mammogram, why would I need an ultrasound, too?An ultrasound offers different information than a mammogram. Most often, doctors order a breast ultrasound exam to answer a specific question about a particular area of the breast. These include abnormalities seen on a mammogram or MRI, or if a patient has a lump or other symptoms, such as pain or nipple discharge, but nothing abnormal is seen on a mammogram. Pregnant patients or young patients (usually under the age of 30) who have symptoms of an abnormality generally undergo an ultrasound before a mammogram.
An ultrasound is particularly useful in distinguishing fluids from solids, so it is often used to detect cysts (small, benign fluid-filled structures within the breast). It sometimes can help tell the difference between benign and cancerous tumors as well.
Can I request an ultrasound instead of a mammogram for my annual screening?While a targeted breast ultrasound can be a helpful diagnostic tool, it is not recommended as part of a routine screening. Our Breast Imaging specialists do not recommend whole breast ultrasound screening unless the patient carries a high risk for breast cancer and for some reason cannot undergo breast Magnetic Resonance Imaging (MRI).
What happens during an ultrasound exam?You will first need to remove any clothing from the waist up, and you will be given an exam gown to wear. Next, you will lie down on a comfortable examination table. The ultrasound technologist places a small amount of clear gel, which doesn’t hurt your skin or stain clothes, on the part of the breast to be examined. The technologist holds a small device, called a transducer, and carefully and gently moves it over the area. The gel helps the transducer make better contact with the skin. Usually, our technologist will need to take several images that appear in “real-time” on a screen that resembles a computer monitor.
Is ultrasound safe?Yes, all studies have shown that ultrasounds are safe. Ultrasounds do not use radiation or X-rays, only sound waves, to obtain images.
What happens when the ultrasound is over?When the technologist has finished the ultrasound examination, the images are shown to the radiologist, who will then perform additional scans to confirm the findings, and may take some more images. Once the appropriate images have been taken by the technologist and radiologist, the gel will be wiped off your skin.
How is an ultrasound used to help guide my breast biopsy procedure?Ultrasounds are very helpful during breast biopsy procedures to confirm the exact location of a cyst or tumor and determine the most accurate needle placement. Often, an ultrasound will also be done before the breast biopsy is performed in order to help plan the procedure.
Does insurance cover all ultrasound exams?Currently, not all insurance providers cover whole breast ultrasound exams, but most cover targeted ultrasound exams. To find out your associated costs, contact your insurance company.
