The Importance of Ultrasound When Determining Suspicious Abnormalities in Breast Tissue

Advancements in image quality and advanced technologies in ultrasound devices such as shearwave imaging can help.

Breast cancer is more common than most people would like to admit. In the U.S., a woman has a 1 in 8 chance of developing breast cancer during their lifetime.1

That’s why the American Cancer Society recommends annual mammograms for women beginning at age 40, and even earlier for those with more risk factors.2 But scheduling and receiving a mammogram can be anxiety provoking, especially if a woman has a family history of breast cancer. If the medical professional should discover something during the exam that warrants further examination, the next step is usually an ultrasound of the breast to help clarify what is seen on mammography and if a biopsy is needed or not. The days spent waiting for biopsy results can be terrifying, so if it can be avoided it can greatly improve a patient’s wellbeing.

Luckily advancements in image quality and advanced technologies in ultrasound devices such as shearwave imaging can help. Shearwave elastographic features provide qualitative and quantitative information that can be added to mammographic BIRADS analysis, allowing sonographers and radiologists to improve specificity of breast ultrasound mass assessment.3 These tools provide the physician with additional information, and possibly eliminate the need for a biopsy.

I’ve seen these benefits first-hand. In my experience, patients will go straight from the first ultrasound scan to a biopsy if suspicious abnormalities are detected within the breast tissue on mammography and ultrasound. In order to change the patient care cycle, giving a patient a second ultrasound prior to a biopsy may help them avoid un-needed tests. I was once performing a pre-biopsy ultrasound with a Samsung RS85 Prestige® and the device’s 2D and S-Shearwave Imaging™ feature showed that the lump was just an intramammary lymph node. This meant there was no reason to biopsy it, so it was canceled.

Another imaging tool that simplifies and enhances the screening process is a feature called S-Detect™. The semi-automated reporting feature tool analyzes selected lesions and is able to define margins clearly so the user knows a more precise distance from the nipple and depth of the lesion. This is very helpful for documentation and provides clear information on follow-up visits. There is also an ergonomic benefit. In many cases, a sonographer is reaching across the patient’s body to perform a scan. The automated nature of S-Detect reduces the time a sonographer spends on the breast scanning, which therefore reduces time spent in a very uncomfortable position, causing shoulder and arm fatigue. Lastly, it may also give those who are questioning their judgement an extra layer of confidence.

As time goes on, ultrasound manufacturers are moving beyond 2D and 3D imaging, and into the world of advanced intelligence (AI) to construct new ways to display, interpret and understand what is going on inside the human body. S-Detect is a good example of this. Breast ultrasound has become an increasingly common and crucial tool used by medical professionals to determine abnormalities faster and with more confidence. In fact, because image quality and software has advanced to where it has, practitioners have even begun using ultrasound as a first modality to avoid exposing a woman to small amounts of radiation.

When choosing an ultrasound device, medical professionals should consider not only the image quality but also the software and hardware features available in order to improve both their own experience, but, more importantly, the experience of the patient.

REFERENCES
1. American Cancer Society. How Common is Breast Cancer? https://www.cancer.org/cancer/breast-cancer/about/how-common-is-breast-cancer.html
2. American Cancer Society. Recommendations for the Early Detection of Breast Cancer https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html
3. Berg WA et. al; BE1 Investigators. Shear-Wave Elastography Improves the Specificity of Breast US: The BE1 Multinational Study of 939 Masses. National Library of Medicine. 2012 Feb;262(2). doi: 10.1148/radiol.11110640. PMID: 22282182.