Breast cancer echocardiography or ultrasound

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2] Mirdula Sharma, MBBS [3]; Ammu Susheela, M.D. [4]

Overview

Breast ultrasound may be helpful in the diagnosis of breast cancer.

Findings on ultrasound

• Breast ultrasound is not as sensitive as mammography in diagnosing breast cancer.
• It may be used to:

• Examine a breast lump or abnormality found during a clinical breast examination or mammogram
• Determine if a breast lump is a solid tumor or a fluid-filled cyst (sac in the body that is usually filled with fluid or semi-solid material)
• Find an abnormal area for a biopsy
• To evaluate the local extent of breast cancer
• To identify axillary nodes suspicious for metastasis

• The addition of ultrasound decreases the false negative rate of diagnostic mammography, but we should keep in mind that a negative ultrasound and/or mammography does do not exclude the presence of breast cancer.
• US is the first line imaging modality in:

• Pregnant women
• Women less than 30 years old with focal breast sign and symptoms

• Color Doppler ultrasound:

• May aid in the assessment of breast masses
• The absence of flow on Doppler study does not exclude the possibility of malignancy.

Liver Ultrasound

If the blood chemistry tests show increased levels of liver enzymes, a liver ultrasound may be done to check if cancer has spread to the liver (liver metastases).

Herceptin (trastuzumab) induced heart failure

• Trastuzumab is a HER2 receptor blocker, which is used to treat HER2 positive breast cancer.
• It has been shown that heart failure is prevalent in women being treated with this novel treatment.
• According to a small study 58% of women treated with Herceptin for three months, showed pieces of evidence of loss of heart function. (Ref)
• As a potentially serious side effect of this novel treatment serial Echocardiography is recommended in all patients treated with trastuzumab.