A breast ultrasound uses sound waves, not radiation, to build a detailed picture of the tissue inside your breast. It is quick and painless, and because the images appear on screen as the scan happens, the specialist doing it can talk you through what they are seeing in real time.
Whether you have been asked to have one after a lump was felt, or you have booked one yourself for peace of mind, knowing what to expect makes the appointment far less daunting. Here is what actually happens.
breast lumps turn out not to be cancer
View as table
| Statistic | Value |
|---|---|
| breast lumps turn out not to be cancer | 8 in 10 |
Source: NHS, breast lumps: commonly quoted clinical estimate.
01What a breast ultrasound is
A breast ultrasound is performed by a consultant radiologist, who applies a water-based gel to the skin and moves a handheld probe, a transducer: across the breast. The probe sends out harmless sound waves and picks up the echoes as they bounce back off your tissue; a computer turns those echoes into a live image on the screen.
It is non-invasive, painless and uses no radiation at all, which is part of why it is often the first imaging test used in younger women, and in anyone who is pregnant or breastfeeding.
Seeing the images as we scan, rather than waiting for someone else to read them later, is what makes ultrasound so reassuring for patients.
Dr Ayman Mahfouz, consultant radiologist
02When a breast ultrasound is recommended
A breast ultrasound is usually recommended when there is something specific to look at, though plenty of women book one simply for reassurance. It is typically used for:
- A new lump, thickening or area of concern felt in the breast
- Breast pain that is persistent, one-sided or otherwise worrying
- A change in the size, shape or skin of the breast
- Nipple discharge, inversion or a change around the nipple
- A concern about breast implants
- A follow-up to an abnormal mammogram, or a lump found on self-examination
Ultrasound is also a useful partner to mammography rather than a replacement for it. It can pick out small lumps that a mammogram misses, particularly in denser breast tissue, and it is very good at telling a fluid-filled cyst from a solid lump, which a mammogram alone cannot always do.
03What to expect on the day
There is nothing to prepare in advance. This is the shape of a typical appointment:
- 1
History and risk factors
The specialist asks about your symptoms, any family history of breast cancer, and previous breast biopsies or surgery, so the scan is read in context.
- 2
The scan itself
A cool, water-based gel is applied and the probe is moved gently over the breast. It does not hurt: you may feel light pressure, nothing more.
- 3
The armpit too
The specialist also checks the lymph nodes under your arm, since breast health and the nearby lymph nodes are always assessed together.
- 4
Findings, explained
Because the specialist reading the scan is the one holding the probe, you get a running explanation rather than a wait for a written report.
- History and risk factors5 min
- The scan15 min
- Findings explained10 min
View as table
| Part of the visit | Typical time |
|---|---|
| History and risk factors | about 5 minutes |
| The scan | about 15 minutes |
| Findings explained | about 10 minutes |
04What a breast ultrasound can show
Ultrasound is very good at telling different kinds of breast tissue apart. Findings generally fall into a small number of groups:
- Benign lumps, fibroadenomas (solid, made of glandular and fibrous tissue), simple cysts (harmless and fluid-filled) and small cysts just under the skin.
- Cancerous lumps, any mass with features that need further investigation, usually with a biopsy.
- Infection, mastitis, most common in breastfeeding women, and abscesses, a collection of pus within the breast tissue.
- Pregnancy-related changes, lactating adenomas and galactoceles, both benign and linked to pregnancy or breastfeeding.
- Findings of uncertain risk, such as a papilloma, a small wart-like growth inside a milk duct, which is usually monitored or sampled.
Not every finding is a lump you can feel, and not every breast cancer shows up as an obvious mass, which is one reason ultrasound is often combined with a mammogram, a biopsy, or both, rather than used alone.
05How the images are read
On the screen, breast tissue appears in shades of grey, white and black depending on how dense it is. As a general rule, fluid-filled areas, like a simple cyst: look dark, while solid areas look lighter; but colour alone is never the whole story. Size, shape, edges and how a lump behaves are all part of the picture.
That is why interpreting an ultrasound takes real training and experience, and why it is usually read alongside your history, a mammogram where relevant, and sometimes a biopsy, not in isolation.
06Your results and what happens next
Most women leave their appointment with a clear answer and nothing further to arrange. If something does need a closer look, you will not be sent away to wait for a letter. Your specialist tells you in the room and agrees the next step with you before you leave.
07How to prepare
There genuinely is very little to do beforehand.
- Wear a two-piece outfit. You will need to undress to the waist for the scan.
- Bring any previous imaging. If you have had a breast scan or mammogram elsewhere, bring the report, or let us know where it was done.
The scan itself takes around 30 minutes, and there is no downtime afterwards. You can go straight back to your day.
