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Breast Ultrasound
Breast ultrasound uses sound waves and their echoes to make images of the inside of the breast. It is not used routinely as a part of breast cancer screening, but it can be used to diagnose breast problems, including cancer.
When is breast ultrasound used?
Ultrasound is used to help diagnose breast problems. Ultrasound is widely available, fairly easy to have done, and it does not expose a person to radiation. It also tends to cost less than other testing options.
Some examples of when a breast ultrasound could be used include:
- Looking at an area that was abnormal on a mammogram.
- Looking at a lump or mass to see whether it is a cyst, which is unlikely to be cancer, or a solid mass, which might need further testing to find out whether it’s cancer.
- Evaluating nipple discharge or skin changes over the breast.
- Guiding a biopsy needle into an abnormal area seen on breast imaging tests so that the cells can be removed and tested for cancer.
- Measuring and marking a known breast cancer to watch for treatment response or cancer recurrence. This is often done at the time of a biopsy with a small clip that shows up on imaging tests.
How is a breast ultrasound done?
Most often, ultrasound is done using a handheld, wand-like instrument called a transducer. First, a gel is applied and then the transducer is moved around over the skin.
You might feel some pressure as the transducer is moved around on your skin, but it should not be painful.
Automated breast ultrasound (ABUS) is an option at some imaging centers. This technique uses a much larger transducer to take hundreds of images that cover nearly the entire breast. ABUS might be done as an added screening exam for people who have dense breasts. It might also be used in people who have abnormal findings on other imaging tests or who have breast symptoms. When ABUS is done, a second handheld ultrasound might be needed to get more pictures of any suspicious areas.
How are breast ultrasound results reported?
Doctors use the Breast Imaging Reporting and Data System or BI-RADS to describe results of mammograms, breast ultrasounds, and breast MRIs. This system sorts the results into categories numbered 0 through 6. Using the BI-RADS system makes communicating about these test results and following up after the tests much easier.
Although the categories are the same for each of these imaging tests, the recommended next steps after these tests might be different. For more details on the BI-RADS categories, see Understanding Your Mammogram Report.
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- References
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
American College of Radiology. ACR BI-RADS ATLAS – Breast Ultrasound. Reporting System. 2013. Accessed at https://www.acr.org/-/media/ACR/Files/RADS/BI-RADS/US-Reporting.pdf on November 29, 2021.
Depretto C, Liguori A, Primolevo A, et al. Automated breast ultrasound compared to hand-held ultrasound in surveillance after breast-conserving surgery. Tumori. 2021;107(2):132-138.
Esserman LJ. Diagnostic evaluation of suspected breast cancer. UpToDate. 2026. Accessed at https://www.uptodate.com/contents/diagnostic-evaluation-of-suspected-breast-cancer on March 18, 2026.
Hatzipanagiotou ME, Huber D, Gerthofer V, et al. Feasibility of ABUS as an Alternative to Handheld Ultrasound for Response Control in Neoadjuvant Breast Cancer Treatment. Clin Breast Cancer. 2022;22(2):e142-e146.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Breast Cancer Screening and Diagnosis Version 1.2026 – March 5, 2026. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/breast-screening.pdf on March 18, 2026.
Rella R, Belli P, Giuliani M, et al. Automated breast ultrasonography (ABUS) in the screening and diagnostic setting: Indications and practical use. Acad Radiol. 2018;25(11):1457-1470.
Slanetz PJ, Lee CI. Breast imaging for cancer screening: Mammography and ultrasonography.
UpToDate. 2026. Accessed at https://www.uptodate.com/contents/breast-imaging-for-cancer-screening-mammography-and-ultrasonography on April 13, 2026.
Last Revised: July 23, 2026
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