Ultrasound is a great help in screening breast cancer!

Author: David, chief physician of Beijing Hospital

Reviewer: Liang Zhen, Chief Physician, Peking University Cancer Hospital

Among all female malignant tumors, the incidence of breast cancer ranks first, and it is highly malignant and causes great harm. It is necessary for us to pay great attention to it and try our best to diagnose and treat it early.

Ultrasound examination is convenient and non-invasive, and is of great significance for the diagnosis and treatment of breast cancer.

1. What is the application value of ultrasound in breast cancer screening?

First, ultrasound equipment is updated very quickly, with a new batch being replaced about every five years, and some of its performance is also improving very quickly, so the ultrasound equipment used by doctors now has a very high resolution. Even a small lump of two or three millimeters can be easily detected by ultrasound, so ultrasound is the most widely used in breast disease screening.

Second, in addition to determining whether there is a lump in the breast, ultrasound examination can also determine the location, size, shape, etc. of the lump, and can provide very detailed information.

Third, color Doppler ultrasound can be used to examine the blood flow distribution within breast masses, and is also very helpful in determining the nature of breast masses.

Fourth, the newly developed ultrasonic elastography, also known as E-ultrasound, can be used to detect the hardness of breast lumps.

Figure 1 Original copyright image, no permission to reprint

Early breast cancer is actually very small, maybe even just one or two millimeters, or two or three millimeters. Combining conventional ultrasound, color Doppler ultrasound, and elastic imaging can significantly improve the detection rate of early breast cancer, which is very meaningful. Now, breast ultrasound screening has been given a very important position in hospital physical examinations.

The second is breast cancer screening in the community. In fact, ultrasound examination is the most commonly used method. Therefore, the combination of these two aspects is very helpful for the early diagnosis and treatment of breast cancer.

2. What preparations do patients need to make before breast ultrasound examination?

The first is the time of examination. If you are a woman of childbearing age, you must do the examination 3-7 days after menstruation, which is more accurate. Because if you do it during menstruation or before menstruation, the breast changes with the physiological period, and the examination results will be affected.

But in fact, sometimes it is not easy to guarantee the time, because hospitals usually have a lot of patients, and you may have to come on the same day you make an appointment, so you should explain the situation to the doctor at that time, so that the doctor can make a relatively objective judgment based on the actual situation.

Figure 2 Original copyright image, no permission to reprint

The second is what you wear during the examination. You must pay attention to this aspect. You must wear separate clothes with top and pants, because for a breast ultrasound examination, you must take off your top completely, exposing your breasts and armpits, so that the examination can be more thorough.

Third, if there is nipple discharge, no matter what color it is, you need to check the condition of the breast. Try not to squeeze out the liquid at this time, because when there is liquid, the duct is in an expanded state, so it will be very clear under ultrasound. Once a part of it is squeezed out, it will not be so easy to find the problem during ultrasound examination.

Fourth, after the ultrasound examination, issues related to interventional diagnosis may be involved, and some further checks may be needed, such as routine blood tests, coagulation time, and four infection items. These are all necessary checks before interventional diagnosis.

3. Why do we need to check the axillary lymph nodes when doing breast ultrasound examination?

Because axillary lymph nodes are very important for breast diseases, they are the first stop for breast lymphatic drainage. If there is a problem with the breast, especially breast cancer, the closest site of metastasis is the axillary lymph nodes.

First, in terms of diagnosis, sometimes the clinic finds that many breast examinations show no problems, but the axillary lymph nodes have grown larger, and after interventional puncture, it is found that breast cancer has metastasized to the axillary lymph nodes. This is called occult breast cancer. That is, the breast cancer lesions are not found, but there are problems with the axillary lymph nodes, which in turn indicates the presence of breast cancer and requires further examination.

Secondly, in terms of treatment, it is also very important to check the axillary lymph nodes in addition to the breast when the patient is reexamined with color Doppler ultrasound after surgery. Axillary lymph nodes and breast diseases are closely related, and ultrasound is very powerful in detecting superficial lymph nodes, so as long as there are changes in shape, number, and internal structure, ultrasound can detect them.

In addition, if there is a clinical suspicion of a problem with the axillary lymph nodes, a puncture biopsy can be performed. The biopsy can be as small as two millimeters. If a problem is found, fine needle puncture can be performed, which can provide a clear diagnosis as soon as possible without delaying the patient's condition, which is very beneficial.