Ultrasound in the changing approaches to breast cancer diagnosis and treatment.

Advances in ultrasound technology have not only refined this modality for diagnostic purposes, but have also extended its utility to the realm of treatment. Specific patient populations benefit from the addition of ultrasound to mammographic screening, such as those with BRCA-1 or BRCA-2 mutations or a personal or family history of breast cancer. Ultrasound is of particular benefit in guiding wire localization under sedation, as well as in guiding core biopsies and fine-needle aspirations. Current ablative techniques, including radiofrequency, cryoablation and laser, are now incorporating ultrasound guidance to maximize efficacy. Furthermore, ultrasound has been found to have significant utility in guiding preablative core biopsies for definitive diagnosis, estrogen receptor (ER)/progesterone receptor (PR), HER-2/neu, and other markers. As a result of its proven utility, ultrasound is now undergoing evaluation for use in the removal of malignant breast lesions.