Breast ultrasound

recommendations for information to women and referring physicians by the European Society of Breast Imaging

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Abstract

This article summarises the information that should be provided to women and referring physicians about breast ultrasound (US). After explaining the physical principles, technical procedure and safety of US, information is given about its ability to make a correct diagnosis, depending on the setting in which it is applied. The following definite indications for breast US in female subjects are proposed: palpable lump; axillary adenopathy; first diagnostic approach for clinical abnormalities under 40 and in pregnant or lactating women; suspicious abnormalities at mammography or magnetic resonance imaging (MRI); suspicious nipple discharge; recent nipple inversion; skin retraction; breast inflammation; abnormalities in the area of the surgical scar after breast conserving surgery or mastectomy; abnormalities in the presence of breast implants; screening high-risk women, especially when MRI is not performed; loco-regional staging of a known breast cancer, when MRI is not performed; guidance for percutaneous interventions (needle biopsy, pre-surgical localisation, fluid collection drainage); monitoring patients with breast cancer receiving neo-adjuvant therapy, when MRI is not performed. Possible indications such as supplemental screening after mammography for women aged 40-74 with dense breasts are also listed. Moreover, inappropriate indications include screening for breast cancer as a stand-alone alternative to mammography. The structure and organisation of the breast US report and of classification systems such as the BI-RADS and consequent management recommendations are illustrated. Information about additional or new US technologies (colour-Doppler, elastography, and automated whole breast US) is also provided. Finally, five frequently asked questions are answered.

TEACHING POINTS: • US is an established tool for suspected cancers at all ages and also the method of choice under 40. • For US-visible suspicious lesions, US-guided biopsy is preferred, even for palpable findings. • High-risk women can be screened with US, especially when MRI cannot be performed. • Supplemental US increases cancer detection but also false positives, biopsy rate and follow-up exams. • Breast US is inappropriate as a stand-alone screening method.

Original languageEnglish
Pages (from-to)449-461
Number of pages13
JournalInsights into Imaging
Volume9
Issue number4
Early online date9 Aug 2018
DOIs
Publication statusPublished - Aug 2018

Fingerprint

Women Physicians
Breast
Magnetic Resonance Imaging
Mammography
Breast Neoplasms
Breast Implants
Biopsy
Elasticity Imaging Techniques
Segmental Mastectomy
Nipples
Mastectomy
Physiologic Monitoring
Needle Biopsy
Cicatrix
Drainage
Neoplasms
Color
Inflammation
Technology
Safety

Keywords

  • Automated whole breast ultrasound
  • BI-RADS
  • Breast cancer
  • Breast ultrasound (US)
  • Colour-Doppler
  • Elastography

Cite this

@article{096154ea2d20412293a9f7c912c788f3,
title = "Breast ultrasound: recommendations for information to women and referring physicians by the European Society of Breast Imaging",
abstract = "This article summarises the information that should be provided to women and referring physicians about breast ultrasound (US). After explaining the physical principles, technical procedure and safety of US, information is given about its ability to make a correct diagnosis, depending on the setting in which it is applied. The following definite indications for breast US in female subjects are proposed: palpable lump; axillary adenopathy; first diagnostic approach for clinical abnormalities under 40 and in pregnant or lactating women; suspicious abnormalities at mammography or magnetic resonance imaging (MRI); suspicious nipple discharge; recent nipple inversion; skin retraction; breast inflammation; abnormalities in the area of the surgical scar after breast conserving surgery or mastectomy; abnormalities in the presence of breast implants; screening high-risk women, especially when MRI is not performed; loco-regional staging of a known breast cancer, when MRI is not performed; guidance for percutaneous interventions (needle biopsy, pre-surgical localisation, fluid collection drainage); monitoring patients with breast cancer receiving neo-adjuvant therapy, when MRI is not performed. Possible indications such as supplemental screening after mammography for women aged 40-74 with dense breasts are also listed. Moreover, inappropriate indications include screening for breast cancer as a stand-alone alternative to mammography. The structure and organisation of the breast US report and of classification systems such as the BI-RADS and consequent management recommendations are illustrated. Information about additional or new US technologies (colour-Doppler, elastography, and automated whole breast US) is also provided. Finally, five frequently asked questions are answered.TEACHING POINTS: • US is an established tool for suspected cancers at all ages and also the method of choice under 40. • For US-visible suspicious lesions, US-guided biopsy is preferred, even for palpable findings. • High-risk women can be screened with US, especially when MRI cannot be performed. • Supplemental US increases cancer detection but also false positives, biopsy rate and follow-up exams. • Breast US is inappropriate as a stand-alone screening method.",
keywords = "Automated whole breast ultrasound, BI-RADS, Breast cancer, Breast ultrasound (US), Colour-Doppler, Elastography",
author = "Andrew Evans and Trimboli, {Rubina M} and Alexandra Athanasiou and Corinne Balleyguier and Baltzer, {Pascal A} and Ulrich Bick and {Camps Herrero}, Julia and Paola Clauser and Catherine Colin and Eleanor Cornford and Fallenberg, {Eva M} and Fuchsjaeger, {Michael H} and Gilbert, {Fiona J} and Helbich, {Thomas H} and Karen Kinkel and Heywang-K{\"o}brunner, {Sylvia H} and Kuhl, {Christiane K} and Mann, {Ritse M} and Laura Martincich and Pietro Panizza and Federica Pediconi and Pijnappel, {Ruud M} and Katja Pinker and Sophia Zackrisson and Gabor Forrai and Francesco Sardanelli",
year = "2018",
month = "8",
doi = "10.1007/s13244-018-0636-z",
language = "English",
volume = "9",
pages = "449--461",
journal = "Insights into Imaging",
issn = "1869-4101",
publisher = "Springer Verlag",
number = "4",

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TY - JOUR

T1 - Breast ultrasound

T2 - recommendations for information to women and referring physicians by the European Society of Breast Imaging

AU - Evans, Andrew

AU - Trimboli, Rubina M

AU - Athanasiou, Alexandra

AU - Balleyguier, Corinne

AU - Baltzer, Pascal A

AU - Bick, Ulrich

AU - Camps Herrero, Julia

AU - Clauser, Paola

AU - Colin, Catherine

AU - Cornford, Eleanor

AU - Fallenberg, Eva M

AU - Fuchsjaeger, Michael H

AU - Gilbert, Fiona J

AU - Helbich, Thomas H

AU - Kinkel, Karen

AU - Heywang-Köbrunner, Sylvia H

AU - Kuhl, Christiane K

AU - Mann, Ritse M

AU - Martincich, Laura

AU - Panizza, Pietro

AU - Pediconi, Federica

AU - Pijnappel, Ruud M

AU - Pinker, Katja

AU - Zackrisson, Sophia

AU - Forrai, Gabor

AU - Sardanelli, Francesco

PY - 2018/8

Y1 - 2018/8

N2 - This article summarises the information that should be provided to women and referring physicians about breast ultrasound (US). After explaining the physical principles, technical procedure and safety of US, information is given about its ability to make a correct diagnosis, depending on the setting in which it is applied. The following definite indications for breast US in female subjects are proposed: palpable lump; axillary adenopathy; first diagnostic approach for clinical abnormalities under 40 and in pregnant or lactating women; suspicious abnormalities at mammography or magnetic resonance imaging (MRI); suspicious nipple discharge; recent nipple inversion; skin retraction; breast inflammation; abnormalities in the area of the surgical scar after breast conserving surgery or mastectomy; abnormalities in the presence of breast implants; screening high-risk women, especially when MRI is not performed; loco-regional staging of a known breast cancer, when MRI is not performed; guidance for percutaneous interventions (needle biopsy, pre-surgical localisation, fluid collection drainage); monitoring patients with breast cancer receiving neo-adjuvant therapy, when MRI is not performed. Possible indications such as supplemental screening after mammography for women aged 40-74 with dense breasts are also listed. Moreover, inappropriate indications include screening for breast cancer as a stand-alone alternative to mammography. The structure and organisation of the breast US report and of classification systems such as the BI-RADS and consequent management recommendations are illustrated. Information about additional or new US technologies (colour-Doppler, elastography, and automated whole breast US) is also provided. Finally, five frequently asked questions are answered.TEACHING POINTS: • US is an established tool for suspected cancers at all ages and also the method of choice under 40. • For US-visible suspicious lesions, US-guided biopsy is preferred, even for palpable findings. • High-risk women can be screened with US, especially when MRI cannot be performed. • Supplemental US increases cancer detection but also false positives, biopsy rate and follow-up exams. • Breast US is inappropriate as a stand-alone screening method.

AB - This article summarises the information that should be provided to women and referring physicians about breast ultrasound (US). After explaining the physical principles, technical procedure and safety of US, information is given about its ability to make a correct diagnosis, depending on the setting in which it is applied. The following definite indications for breast US in female subjects are proposed: palpable lump; axillary adenopathy; first diagnostic approach for clinical abnormalities under 40 and in pregnant or lactating women; suspicious abnormalities at mammography or magnetic resonance imaging (MRI); suspicious nipple discharge; recent nipple inversion; skin retraction; breast inflammation; abnormalities in the area of the surgical scar after breast conserving surgery or mastectomy; abnormalities in the presence of breast implants; screening high-risk women, especially when MRI is not performed; loco-regional staging of a known breast cancer, when MRI is not performed; guidance for percutaneous interventions (needle biopsy, pre-surgical localisation, fluid collection drainage); monitoring patients with breast cancer receiving neo-adjuvant therapy, when MRI is not performed. Possible indications such as supplemental screening after mammography for women aged 40-74 with dense breasts are also listed. Moreover, inappropriate indications include screening for breast cancer as a stand-alone alternative to mammography. The structure and organisation of the breast US report and of classification systems such as the BI-RADS and consequent management recommendations are illustrated. Information about additional or new US technologies (colour-Doppler, elastography, and automated whole breast US) is also provided. Finally, five frequently asked questions are answered.TEACHING POINTS: • US is an established tool for suspected cancers at all ages and also the method of choice under 40. • For US-visible suspicious lesions, US-guided biopsy is preferred, even for palpable findings. • High-risk women can be screened with US, especially when MRI cannot be performed. • Supplemental US increases cancer detection but also false positives, biopsy rate and follow-up exams. • Breast US is inappropriate as a stand-alone screening method.

KW - Automated whole breast ultrasound

KW - BI-RADS

KW - Breast cancer

KW - Breast ultrasound (US)

KW - Colour-Doppler

KW - Elastography

U2 - 10.1007/s13244-018-0636-z

DO - 10.1007/s13244-018-0636-z

M3 - Article

VL - 9

SP - 449

EP - 461

JO - Insights into Imaging

JF - Insights into Imaging

SN - 1869-4101

IS - 4

ER -