Ultrasound Evaluation in Female Patients
Indications for Ultrasound
- For women ≥30 years with a palpable breast mass, both diagnostic mammogram and ultrasound are recommended, as per the National Comprehensive Cancer Network, for accurate diagnosis 3, 4
- For women <30 years with a palpable breast mass, ultrasound is the preferred initial imaging modality, according to the National Comprehensive Cancer Network, due to its sensitivity in detecting breast abnormalities 3, 4
- The American College of Radiology recommends sonohysterography (saline infusion sonography) for further characterization of endometrial abnormalities when initial ultrasound for abnormal uterine bleeding is inconclusive 6
- For probably benign findings (BI-RADS 3), the National Comprehensive Cancer Network recommends follow-up ultrasound every 6 months for 1-2 years 4
- For isolated soft markers on previous ultrasound, such as choroid plexus cysts or echogenic intracardiac focus, in pregnant women, no further ultrasound evaluation is needed if serum or cfDNA screening results are negative, as per the American Journal of Obstetrics and Gynecology 1, 2
Clinical Decision-Making
- The National Comprehensive Cancer Network suggests identifying the specific clinical finding or concern, such as palpable breast mass, breast asymmetry/thickening, or nipple discharge, to guide the choice of imaging modality 3, 5
- Considering patient age is crucial, as women <30 years may require only ultrasound, while those ≥30 years may need a combined approach with mammogram and ultrasound, according to the National Comprehensive Cancer Network 3, 4