In recent years, the media occasionally report the news that some celebrities or public figures passed away due to breast cancer, which makes many women start to pay attention to the ultrasound examination of breast. What should we do after finding a breast nodule?
A breast nodule is usually a disease in which a lump is created inside the breast tissue due to structural changes.
After finding a breast nodule, do not panic because lobular hyperplasia, breast fibroadenoma, breast papilloma, breast cyst, mastitis and breast cancer can all manifest as breast lumps. Patients can first identify the benignity or malignancy of breast lumps by means of breast ultrasound, mammography and breast MRI. For women around the age of menopause, if a painless lump is found in the breast, it should be taken seriously.
I. Normal breast tissue structure
Because of its convenience and non-invasive advantages, breast ultrasound, together with mammography, is known as the “golden combination” and is currently recognized as the most common and effective means of screening for breast nodules. However, because mammography is less diagnostic for Asian women with dense breasts and has a certain amount of radiation, the American Cancer Society does not recommend it for women younger than 35 years old.
II. Advantages of breast ultrasound examination
Non-invasive and non-radioactive, also suitable for pregnant and lactating women;
Great value in identifying cystic or solid breast tumors;
Multi-angle and multi-level scanning can be performed, clearly showing the anatomical structure of the breast and lesion information;
It can clearly show the presence of enlarged lymph nodes in the axilla and the size, shape and structure of the enlarged lymph nodes.
Nowadays, ultrasound diagnosis of breast nodules is performed using the Breast Imaging Reporting and Data System (BI-RADS) developed by the American College of Radiology (ACR).
Data System (BI-RADS).
BI-RADS is classified into 0-6 levels:
Grade 0 is an incomplete evaluation and needs to be combined with other imaging studies to make a final evaluation;
Grades 1-3 tend to be benign and require regular follow-up;
Grade 4 (4a, 4b, 4c) is suspicious for malignant lesions and should be considered for puncture biopsy;
Grade 5 is almost certainly a malignant lesion and appropriate measures should be taken by breast surgery;
Grade 6 is pathologically diagnosed as malignant.
BI-RADS grading of breast nodules
Examples are shown in the figure above.
Figure A-Breast cyst (BI-RADS grade 2)
Figure B-Fibroadenoma of the breast (BI-RADS grade 3)
Figure C-Intraductal papilloma of the breast (BI-RADS grade 4)
Figure D – Breast cancer (BI-RADS grade 5)
Today, new ultrasound techniques, such as ultrasonography, elastography, and automated full-volume breast scan imaging, can also provide richer information for the diagnosis and differential diagnosis of breast nodules.