What are future directions of breast ultrasonography?

Updated: Jan 24, 2017
  • Author: Durre Sabih, MBBS, MSc, FRCP(Edin); Chief Editor: Mahan Mathur, MD  more...
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As ultrasound imaging technology advances, new methods offer incremental information over what basic scanning can yeild. Some of the newer ways of processing the image and display are already noted, [9] and these include elastography and microcalcification imaging.

The World Federation of Ultrasound in Medicine and Biology (WFUMB) has published guidelines on the use of ultrasound elastography for breast examination to measure the stiffness of breast tissue. According to the WFUMB, ultrasound elastography has been shown to be highly accurate in characterizing breast lesions as benign or malignant. Cancer tissue is stiffer than normal breast tissue, and it is believed that the tissue stiffening begins in the early stage of cancer. The Tsukuba score is a 5-point scale for grading the stiffness of a mass, but other methods of interpretation (eg, lesion-to-fat ratio) have been shown to be effective. [18]

Three-dimensional ultrasound adds additional features to the image and is slowly refining benign and malignant characteristics of breast masses. It is now known that many malignant lesions can have smooth contours, be wider than tall, and show acoustic enhancement, while benign lesions can have marked irregularity of contour. [20] Other areas of progress include contrast-enhanced ultrasound, which might find use in sentinel node scanning and complement or replace radionuclide methods. Automated breast ultrasound systems are already commercially available that scan the whole breast volume and increase the cancer pick-up rate by almost 100% as compared with mammography alone. [21] This technique is especially useful in women with dense breasts in whom mammography offers limited information and sensitivity.

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