What Is a Breast Ultrasound and Why It’s Used? A Patient Guide

At Independent Physicians Medical Center (IPMC) in Northeast Philadelphia, we provide breast ultrasound imaging in a supportive, private environment with experienced sonographers and board-certified radiologists who specialize in breast imaging.

What Is a Breast Ultrasound?

A breast ultrasound uses high-frequency sound waves transmitted through a handheld transducer to create real-time images of the tissue inside your breast. It can show the size, shape, and internal composition of masses and determine whether they are solid (which may need further evaluation) or fluid-filled (cysts, which are almost always benign).

Breast ultrasound is not a screening replacement for mammography. Rather, it is a complementary tool that provides additional information in specific situations. It is radiation-free and can be performed at any age, including during pregnancy and breastfeeding.

Why Would Your Doctor Order a Breast Ultrasound?

Your doctor may recommend a breast ultrasound to:

• Evaluate a lump found during a physical exam or self-exam — ultrasound is the best test for determining whether a palpable lump is a solid mass or a fluid-filled cyst
• Further evaluate an abnormality seen on mammography — if a mammogram shows a questionable area, ultrasound provides additional characterization
• Examine dense breast tissue — women with dense breasts have more glandular tissue, which appears white on mammography and can mask tumors. Ultrasound can “see through” density and detect masses that mammography may miss
• Evaluate breast pain, skin changes, or nipple discharge when the cause is unclear
• Guide a needle biopsy — real-time ultrasound imaging allows the radiologist to see the needle tip enter a suspicious mass, ensuring an accurate tissue sample. This is called an ultrasound-guided breast biopsy
• Monitor a known breast abnormality — tracking changes in a cyst, fibroadenoma, or other lesion over time
• Supplement mammographic screening in high-risk women — in combination with mammography and sometimes MRI
• Evaluate breast implants — checking for complications such as rupture, although MRI is considered the most sensitive test for this
• Assess young women under 30 with breast complaints — ultrasound is typically the first imaging test used in younger women because breast tissue is usually very dense at this age

  ---

How to Prepare and What Happens

No special preparation is needed. You can eat, drink, and take medications normally. Do not apply lotions, powders, or deodorant to your chest or underarm area before the exam, as these can interfere with the ultrasound transducer.

You’ll undress from the waist up and lie on your back or side on an exam table. The sonographer applies gel to the breast and moves a transducer across the skin, capturing images from multiple angles. If a specific area needs evaluation (such as a mammographic finding), the sonographer will focus on that region. The exam typically takes 15 to 30 minutes per breast and is painless.

Understanding Your Results

A board-certified radiologist will review all images and classify findings using the BI-RADS (Breast Imaging Reporting and Data System) scoring system:

BI-RADS 1 — Negative (normal) BI-RADS 2 — Benign finding (such as a simple cyst) BI-RADS 3 — Probably benign (less than 2% chance of cancer; short-interval follow-up recommended) BI-RADS 4 — Suspicious (biopsy recommended) BI-RADS 5 — Highly suggestive of malignancy (biopsy strongly recommended)

Simple cysts (thin-walled, fluid-filled, with no internal solid components) are almost always benign and typically require no treatment. Solid masses are further evaluated based on their shape, margins, orientation, and internal characteristics.

Results are typically available within 24 to 48 hours. Your doctor will discuss the findings and any recommended follow-up, which may include routine monitoring, a short-interval follow-up ultrasound, or a biopsy.