Breast ultrasound is most commonly performed to evaluate patients with palpable abnormatlities not obvious on a mammogram as well as in particular to evaluate patients of a young age who may not yet qualify for screening mammography.
It has also been recently found that a significant reduction in sensitivity occurs in a patient with dense breast tissue, or category 4 tissue, on screening mammography. In these patients, supplemental ultrasound is commonly recommended.
As the normal breast may feel lumpy to the patient and/or physician, ultrasound can be extremely helpful in excluding pathology and confirming the lumpy consistency to be due to normal breast tissue.
Ultrasound is also helpful in confirming the presence of a cyst which requires no further evaluation unless it is symptomatic, in particular tender or painful. In this case, it can be easily aspirated under ultrasound guidance.
Ultrasound is also commonly used to guide biopsy of the breast when a solid lesion is determined. As there are many benign lesions of the breast, such as fibroadenoma, an ultrasound-guided biopsy in many cases eliminates any need for an open surgical procedure.