Ellen B. Mendelson, MD, FACR

Excellence in Breast Ultrasound

 

Professor of Radiology and Section Chief, Breast and Women's Imaging

Feinberg School of Medicine

Northwestern University,
Northwestern Memorial Hospital

Chicago, Illinois

 

While mammography can help find breast cancer early, some breast cancers may not show up if a woman’s breast tissue is dense.  That’s because, in certain cases, tumors can be hard to differentiate from healthy tissue.

 

Dr. Ellen Mendelson of Northwestern University explains, “On a typical mammogram, normal glandular breast tissue appears white, while fatty tissue looks dark.  The darker areas are more transparent and do not hide things as easily as the dense, white glandular tissue.  What can be obscured by glandular tissue are tumor masses, which appear white.  Against the background of a white, normal breast tissue pattern they may not be evident.”

 

In cases where a mammogram is inconclusive, doctors often turn to ultrasound.

 

Beneficial for some

Most women are aware of ultrasound.  Some are aware of its role in diagnosis of breast disease.  Yet, ultrasound is not used in every instance. “You have to look at every case individually,” says Dr. Mendelson, “to see what the additional benefit of ultrasound would be.”

 

Doctors are more likely to suggest an ultrasound exam if:

 

Ultrasound helps characterize some questionable masses.  It can help determine whether a lump is a cyst (sac containing fluid) or a solid mass.  A cyst is benign and if painful can be drained.  A solid mass may indicate the need for a biopsy.

 

The ACRIN study
Because of her prominence in breast cancer research, Dr. Mendelson was selected to act as the co-investigator in a nationwide study organized by the American College of Radiology Imaging Network (ACRIN) – a national cancer research organization. The research study titled, "Screening Breast Ultrasound in High-Risk Women," aims to confirm whether ultrasound can truly help find breast cancer or suspicious areas that mammography misses.

 

Four years into the study, after imaging 2800 women in over 20 institutions across the country, preliminary findings are about to be released in October.

 

Beyond detection
Dr. Mendelson knows that ultrasound has another key role.  “Ultrasound can be very helpful in directing a percutaneous (through the skin) biopsy.”  Real-time ultrasound images often help doctors guide the needle to its location.  “You can see exactly what you’re doing, as you do it,” says Dr. Mendelson.  “We use ultrasound guided biopsies almost exclusively.” 

She concludes, “While proper breast ultrasound takes a great deal of skill and knowledge of the physics of the ultrasound process, it’s an easy procedure for the patient to tolerate, an easy procedure for the physician to schedule and is a very important technology in the course of breast cancer care.”

- October 2007

 

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