New Technologies in Breast Ca... Video Transcript

Participants

Gillian M. Newstead MD

Summary

When a suspicious mass in the breast is found by mammography or felt by a patient, a follow-up imaging study is usually recommended. One such study, breast ultrasound, has been a proven diagnostic tool for several years. On our webcast, we'll visit a top breast ultrasound suite and go through the process step by step with a real patient. A breast radiologist will be on hand to explain how the procedure works, and discuss how breast ultrasound is used to diagnose the area of concern.

Webcast Transcript

GILLIAN M. NEWSTEAD, MD: My name is Dr. Gillian Newstead, and I'm speaking to you today from the Breast Imaging Center and New York University Medical Center. We're going to be talking about breast ultrasound -- also known as breast sonography.

We use ultrasound a lot in evaluating the pregnant patient, but we also use it to evaluate the heart. We look at the abdomen with ultrasound. And we use it extensively in evaluating the breast.

Ultrasound is really, actually, high-frequency sound waves and we position a high-frequency sound beam onto the skin and we are able to penetrate the structures below the skin and evaluate them by bouncing sound waves off what lies beneath the skin on the internal structure of the organ we're evaluating.

Ultrasound is used as the primary means of evaluating patients under the age of 30 who presents with a breast lump of some kind. We use ultrasound to help decide whether these are solid or cystic in nature.

We use ultrasound, also, to evaluate patients who have breast implants.

FEMALE: Why not go into this room, Room #1.

GILLIAN M. NEWSTEAD, MD: The study itself is actually very painless, it doesn't hurt. The breast is not compressed the way it is for a mammograms.

[Technologist and patient]

FEMALE: Your doctor, when he examined you, did he feel anything on your right breast?

GILLIAN M. NEWSTEAD, MD: The technologist will take a history from the patient and inquire if the patient has noted any changes in her breast or if she's noted any lumps or any areas of particular discomfort. And that helps us direct the ultrasound to the area that we're concerned about.

And we -- to get ready for the ultrasound examination, we place some -- what we call "coupling gel," it's actually jelly, on the transducer itself, which sends and receives the sound. And on the skin of the breast in the area which we want to examine with ultrasound. The get is a coupling agent, and it allows the sound more easily to penetrate into the body.

The patient can look at the screen, the monitor, where we can view the breast and the images we're taking. And what's really nice about the breast ultrasound is the doctor and the technologists can actually see breast in real-time -- the breast tissue -- and then select the areas that look abnormal and take images of that particular area.

And then the radiologist will come and review the findings, usually scan the patient his or herself and take -- may or may not take additional images to confirm the impression that the technologists had. So we work very closely with our technologists.

[Doctor w/ patient]

GILLIAN M. NEWSTEAD, MD: Good morning, I'm Dr. Newstead, how are you?

PATIENT: Good morning.

GILLIAN M. NEWSTEAD, MD: Hi --

PATIENT: A little nervous, a little nervous.

GILLIAN M. NEWSTEAD, MD: Looks like you have a little cyst here, on your breast.

PATIENT: Yes.

GILLIAN M. NEWSTEAD, MD: I'm just going to take a quick look at it, for you and then we'll be all finished.

PATIENT: Okay.

PATIENT: So when I went to the doctor, they said I should come in, and they will do an ultrasound.

It didn't take long. It's not uncomfortable at all. And it was just a matter of sound waves and they showed me on the monitor, you know, what it was that was right below the nipple. Which is the cyst. Said that this was benign and that it -- they'll just keep an eye on it. And if I feel anything unusual, that I should come back. Other than that, they'll see me in a year.

GILLIAN M. NEWSTEAD, MD: Here we have one of the images that we recorded this morning and here we see the mass lesion nicely. It's sharply outlined.