Breast ultrasound and ultrasound guided breast biopsy
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Breast ultrasound and ultrasound-guided breast biopsy. A practical guide Jill Donnelly Breast and General Surgeon. Clarifications: The Triple Assessment Rule Core biopsy and needle aspiration. This presentation applies to Women who have: Breast symptoms of pain &/or lump

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Breast ultrasound and ultrasound guided breast biopsy

Breast ultrasound and ultrasound-guided breast biopsy

A practical guide

Jill Donnelly

Breast and General Surgeon


Breast ultrasound and ultrasound guided breast biopsy

Clarifications:

The Triple Assessment Rule

Core biopsy and needle aspiration


Breast ultrasound and ultrasound guided breast biopsy

This presentation applies to

Women who have:

Breast symptoms of pain &/or lump

Localised to one breast quadrant


Breast ultrasound and ultrasound guided breast biopsy

This presentation does not apply to:

Women having breast screening

Women with:

Nipple symptoms

Diffuse symptoms


Breast ultrasound and ultrasound guided breast biopsy

For women with symptoms of pain &/or a lump localised to one quadrant:

Ultrasound and ultrasound-guided core biopsy are the investigations of choice.

Mammography has no initial role.

90% of patients are in this group.


Breast ultrasound and ultrasound guided breast biopsy

After history, assessment steps:

Step 1.Examination – lump yes or no?

Step 2. Ultrasound symptomatic quadrant.

Discrete lesion – yes or no?

Step 3.If the answer is yes to Step 2 or 3:

core biopsy or needle aspiration is

required.

Step 4.Lesion solid on ultrasound: biopsy

Lesion cystic on ultrasound: aspirate


Breast ultrasound and ultrasound guided breast biopsy

Common breast lumps

Fibroadenoma

Benign breast change (lumpiness)

Cyst

Cancer


Breast ultrasound and ultrasound guided breast biopsy

Benign breast change

No discrete abnormality seen on ultrasound

Requires biopsy because lump present on palpation (Triple Assessment rule)


Breast ultrasound and ultrasound guided breast biopsy

Ultrasound features of benign lumps:

Respect tissue plains

Long axis horizontal

Wall clearly-defined

Posterior brightness (cysts)

Ultrasound features of malignant lumps

Interrupt tissue plains

Long axis vertical

Wall irregular, poorly-defined

Posterior shadowing


Breast ultrasound and ultrasound guided breast biopsy

Summary

If you feel a discrete lump on palpation or see a discrete lump on ultrasound put a needle in it, using ultrasound to guide you.


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