Sonography in the Evaluation of Inflammatory Breast Diseases

George Tsoukatos, BPS, R.T. (R)(ARRT)®*

^*Medical Imaging Consultant, Germantown, NY

Address correspondence to: George Tsoukatos, BPS, R.T. (R)(ARRT)^®*, Radiology Support Services, PO Box 215, Germantown, NY 12526. E-mail: radiologytechnique@gmail.com.

Disclosure Statement: The author reports having no significant financial or advisory relationships with corporate organizations related to this activity.

ABSTRACT

Sonography is a valuable diagnostic modality in breast imaging and is both complimentary and an adjunct to digital mammography, digital breast tomosynthesis, and breast magnetic resonance imaging. Sonography may also be used as an additional breast cancer detection modality in women with dense breasts and a negative mammogram. Currently, sonography is the primary imaging modality recommended for guiding breast biopsies and other interventional breast procedures due to its ability to monitor and assist with real-time needle-to-lesion processes. Overall, sonography has evolved from the early days of B-mode 2-dimensional grayscale images to pulsed duplex, color, power, and spectral Doppler imaging, harmonic and spatial compound imaging, and elastography. It has become an integral component in the effective evaluation of patients with suspicious lesions identified during screening mammograms. Recent developments in sonography imaging systems and transducer technology facilitate accurate differentiation between breast cysts and both benign and malignant solid masses. Proficiency in scanning techniques and instrumentation is crucial for ensuring optimal image quality and facilitating accurate diagnoses. Expertise in this field requires a comprehensive understanding of breast anatomy along with related lymphatic systems and their interactions, imaging techniques and protocols, and proper patient positioning. This course will provide a review state-of-the-art sonographic technology, including recent advances as well as information on whole-breast and targeted sonography relating to benign and malignant inflammatory breast diseases. It will also review breast, nipple, and lymph node anatomy, the American College of Radiology's Breast Imaging Reporting and Data System (BI-RADS) for breast density and abnormality reporting, and provide extensive examples of how many benign and malignant lesions appear on screen.