4/2/2021 1 Breast Ultrasound INDICATIONS NORMAL ANATOMY TECHNIQUE Annina N. Wilkes MD Thomas Jefferson University Hospital • Palpable mass/thickening • Focal Pain • Nipple discharge Women under 30, targeted ultrasound is the first study, mammography as needed Women over 30, bilateral mammogram is the first study, targeted ultrasound to follow INDICATIONS Symptoms INDICATIONS Abnormal Mammogram • Mass • Developing asymmetry/focal asymmetry • Architectural distortion • Calcifications INDICATIONS Abnormal Imaging • MRI • Nuclear medicine • CAT Scan • Contrast Enhanced Mammography (CEM) • Other INDICATIONS Follow up • Probably benign masses (BIRADS 3) – 6 month f/u to assess for stability/2 year • Abscess following antibiotic therapy • Hematoma/seroma • Trauma - bruise INDICATIONS Known or Suspected Malignancy (BIRADS 4,5,6) • Determination of extent, multifocality • Evaluation of axillary lymph nodes • Monitoring response to neoadjuvant chemotherapy – breast, axilla and chest wall • Screening chest wall lymph nodes after therapy
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4/2/2021
1
Breast UltrasoundINDICATIONS
NORMAL ANATOMY
TECHNIQUE
Annina N. Wilkes MD
Thomas Jefferson University Hospital
• Palpable mass/thickening
• Focal Pain
• Nipple discharge
Women under 30, targeted ultrasound is the first study, mammography as needed
Women over 30, bilateral mammogram is the first study, targeted ultrasound to follow
INDICATIONS
Symptoms
INDICATIONSAbnormal Mammogram
• Mass
• Developing asymmetry/focal asymmetry
• Architectural distortion
• Calcifications
INDICATIONSAbnormal Imaging
• MRI
• Nuclear medicine
• CAT Scan
• Contrast Enhanced Mammography (CEM)
• Other
INDICATIONSFollow up
• Probably benign masses (BIRADS 3) – 6 month f/u to assess for stability/2 year
• Abscess following antibiotic therapy
• Hematoma/seroma
• Trauma - bruise
INDICATIONSKnown or Suspected Malignancy (BIRADS 4,5,6)
• Determination of extent, multifocality
• Evaluation of axillary lymph nodes
• Monitoring response to neoadjuvant chemotherapy – breast, axilla and chest wall
• Screening chest wall lymph nodes after therapy
4/2/2021
2
INDICATIONSGuidance
• Cyst aspiration/FNA
• Pre biopsy needle localization/Savi scout placement