When is breast ultrasound useful?
- Targeted assessment of a palpable lump or hardening
- Assessment of selected symptoms, such as focal pain, nipple discharge or signs of inflammation
- Distinguishing fluid-filled cysts from solid findings and imaging follow-up when recommended
- Depending on the question, as first-line imaging in younger patients and during pregnancy or breastfeeding
- As an adjunct to mammography, including in dense breast tissue, when clinically or radiologically indicated
- For people at high breast-cancer risk only as a possible component of a specialist, risk-adapted programme — not as the sole screening test
Procedure
You lie relaxed, we apply ultrasound gel and systematically scan both breasts and axillae. Findings are measured, documented and discussed — you see the image on the monitor.
Strengths of ultrasound
- No ionising radiation and no breast compression
- Targeted assessment of a palpable or otherwise abnormal area
- Good differentiation of many cysts from solid lumps
- Repeatable when medically necessary
- Depending on the question, usable in younger patients and during pregnancy or breastfeeding
Limits
Ultrasound can miss microcalcifications and other changes visible only on mammography; its performance also depends on the clinical question, technique and operator experience. In asymptomatic patients it is therefore not a substitute for screening mammography. Dense breast tissue does not automatically mean that an additional ultrasound is needed: this is decided individually from the imaging findings and risk. For screening between ages 50 and 74, see breast health and screening.
BI-RADS report & next steps
Breast imaging findings are documented using the ACR BI-RADS system, with a final category and a specific management recommendation:
- BI-RADS 0 — incomplete: Additional imaging or comparison with previous studies is needed.
- BI-RADS 1 — negative: No abnormality; routine screening based on age and risk.
- BI-RADS 2 — benign: Benign finding; routine screening based on age and risk.
- BI-RADS 3 — probably benign: Short-interval imaging follow-up, often at 6 months; the report states the exact interval.
- BI-RADS 4 — suspicious: Tissue diagnosis should be considered; 4A, 4B and 4C indicate increasing suspicion.
- BI-RADS 5 — highly suggestive of malignancy: Prompt appropriate action, usually tissue diagnosis and referral to a specialist centre.
- BI-RADS 6: Malignancy already confirmed by biopsy; next steps follow the treatment plan.
A negative or benign imaging category 1 or 2 does not automatically end the work-up of a clinically persistent suspicious lump. We explain the written report and agree the next steps with you: we perform the ultrasound-guided core biopsy in our own practice, with histology at our partner laboratory. Any recommended mammography or MRI is arranged through our network. Depending on the result, further management follows in close cooperation with a certified breast centre.
Costs
When medically indicated, such as for a palpable finding or specific symptoms, the examination may be billed under the usual basic-insurance rules; the deductible (Franchise) and co-payment may apply. Ultrasound without a medical indication is generally self-pay and does not replace mammography screening. We clarify the service and price before the examination.
Clinical sources (accessed 11 July 2026): American College of Radiology (ACR): Reporting Breast Ultrasound / BI-RADS, revised 2 January 2026 · Swiss Cancer League: breast-cancer early detection, updated October 2025. This information does not replace an individual medical assessment.