Breast Ultrasound
Updated on February 12, 2026
A breast ultrasound (also called sonography) is an imaging test that uses sound waves to create detailed digital images of the inside of the breast.
Your doctor might recommend a breast ultrasound to check out a potentially abnormal area in the breast or to help guide the needle during a biopsy procedure. Ultrasound is also sometimes used to screen for breast cancer in people with dense breast tissue, or to check if breast implants have ruptured.
There are two main types of breast ultrasound:
handheld ultrasound (most commonly used)
automated breast ultrasound or ABUS (a newer test used in combination with mammogram to screen women with dense breasts)
Both handheld and automated breast ultrasound are safe, noninvasive, and don't involve any radiation exposure.
An ultrasound may be done of the whole breast (called whole breast ultrasound) or of a specific area in the breast (called limited or targeted breast ultrasound).
It's important to know that ultrasound can't show all the breast changes that may be seen on a mammogram or breast MRI. For example, breast calcifications don't show up as well on ultrasounds as they do on mammograms. However, ultrasounds do sometimes detect breast cancers that weren't detected on mammograms.
How does a breast ultrasound work?
Here's what to expect if you're getting a handheld breast ultrasound:
You'll lie on your back on an exam table while a healthcare provider applies a clear, water-based gel on the skin of your breasts.
The provider will move a wand-like device called a transducer along the skin of your breasts.
The transducer will send and receive sound waves, creating an image that appears on a video monitor during the test.
The healthcare provider may also examine the axilla (the area under the arms) as part of a handheld ultrasound test to see if there are signs that cancer may have spread there.
Here's what to expect if you are getting an automated breast ultrasound (ABUS):
You'll lie on your back on an exam table while a healthcare provider applies a layer of lotion on the skin of your breasts.
The provider will place a transducer that is larger and wider than the one used for traditional handheld ultrasound on the breast and apply gentle pressure.
The provider will take approximately three scans of each breast.
A breast ultrasound test typically takes between 15 and 30 minutes to complete. It may take longer if a biopsy is being done.
Ultrasound and dense breast screening
In some cases, doctors recommend that people with dense breast tissue get routine breast ultrasounds for screening in addition to mammograms.
Ultrasounds and breast MRIs can sometimes detect breast cancers in people with dense breast tissue that mammograms miss. However, those tests would almost always be used in addition to mammograms, not in place of them. People who get screening mammograms and breast ultrasound or breast MRI typically alternate every six months between one type of imaging, then the other. So people getting supplemental screening would typically get, for example, a mammogram once a year and a breast ultrasound or breast MRI once a year. Which supplemental screening method your doctor recommends may depend on factors such as your risk of breast cancer, what’s more available in your area, and what your insurance will cover.
Knowing your breast density and whether you’re at higher-than-average risk for breast cancer can help you and your doctor decide if supplemental screening makes sense for you. To find out your breast density, you can get a mammogram and read your mammogram report. To find out your personal risk for breast cancer, ask your doctor to do a risk assessment.
Research suggests that supplemental screening with ultrasound is especially beneficial for people who have other factors that put them at higher-than-average risk for breast cancer (in addition to having dense breasts).
When is breast ultrasound used?
Your doctor might recommend a breast ultrasound for a variety of reasons besides screening:
To check on a suspicious area in the breast
Doctors use ultrasound to look at potentially abnormal areas seen on a mammogram or breast MRI or felt on a physical exam of the breast. For example, an ultrasound is one of the best ways to find out if a lump is solid (such as a benign fibroadenoma or cancer) or filled with fluid (such as a benign cyst). People under the age of 30 and those who are pregnant often receive ultrasound before any other imaging tests because ultrasound doesn’t involve any radiation exposure. An ultrasound would never be used alone to diagnose breast cancer; other tests (including a breast biopsy) are always needed to make a diagnosis.
To guide the needle during a biopsy
Ultrasound can be used to help precisely guide a needle to a suspicious area in the breast or underarm lymph nodes so that a sample of tissue can be removed and tested for cancer. This is called an ultrasound-guided biopsy. (Note that doctors don't always use the same type of breast imaging for the biopsy that was used to initially detect the suspicious area in the breast. For example, sometimes a suspicious area is detected using breast MRI and ultrasound is used to guide the biopsy needle).
To check lymph nodes for cancer
Doctors may recommend an ultrasound of the underarm lymph nodes to help see if cancer may have spread there from the breast and decide if a biopsy of the lymph nodes or surgery to remove any lymph nodes is needed. This may be done before breast cancer surgery.
To look for implant rupture
If you have silicone gel-filled breast implants, the U.S. Food and Drug Administration (FDA) recommends periodic imaging with breast ultrasound or breast MRI to check if the implants have ruptured. The first ultrasound or MRI should take place five to six years after the initial implant surgery and then every two to three years after that. Breast ultrasound can also be used to check if saline-filled breast implants have ruptured (but usually it’s easier to tell if saline-filled implants rupture without doing an imaging test, because they tend to visibly deflate).
Preparing for a breast ultrasound
Some things you may want to do to get ready for your breast ultrasound appointment:
Check with your insurance company to see what's covered and if you need them to authorize the test beforehand. You might have some out-of-pocket costs, such as a deductible or coinsurance.
Make sure you have a healthcare provider’s order (prescription) for the ultrasound.
If your doctor has recommended that you receive an ultrasound as well as a mammogram for breast cancer screening, for convenience you might want to see if you can schedule the tests on the same day.
Wear a top with pants, shorts, or a skirt on the day of your ultrasound. Since you’ll have to undress above the waist, you may be more comfortable if you wear a two-piece outfit instead of a dress or jumpsuit.
Don’t wear deodorant, antiperspirant, lotion, or powder under your arms on your chest area or breast skin on the day of your ultrasound. Particles from these products can show up on your ultrasound images.
Getting breast ultrasound results
A radiologist (a doctor who specializes in interpreting medical images) will analyze the images from your ultrasound. Many radiologists use computer-aided detection (CAD) and artificial intelligence software to help find any areas on the breast ultrasound that may be abnormal.
The radiologist will send the images and a written report about the results to the doctor who ordered the test.
You should also receive a written report by mail and/or through a patient portal. If you want a copy of the images, you can request to have them given to you on a CD.
Radiologists use a scoring system called the Breast Imaging Reporting and Database System (BI-RADS) to report what they find on your ultrasound. The summary of your ultrasound results that is sent to the doctor always includes BI-RADS scores.
You may receive a call from the doctor who ordered the test or a call from the breast imaging facility to tell you about your results. If the radiologist saw something on the ultrasound that requires additional testing, usually you’ll receive a call shortly after the test.
Paying for a breast ultrasound
It’s always a good idea to contact your health insurance company before you have a breast ultrasound and ask if the test is covered and if you’ll have any out-of-pocket costs (such as a deductible, co-pay, or co-insurance). Also, ask if the insurance company needs to authorize the test beforehand for it to be covered.
If a breast ultrasound is being used for breast cancer screening, it may not always be covered in all states and by all insurance companies. You and your doctor might want to make the case to the insurance company to cover it. Some states have laws about insurance coverage for supplemental breast cancer screening tests.
Is ultrasound an alternative to mammography?
Recently, some online influencers have promoted the idea of getting ultrasounds alone as an alternative to getting mammograms to screen for breast cancer. They claim that the radiation from mammograms makes them an unsafe test.
Mammograms are the most reliable type of imaging for breast cancer screening. While it’s true that you’re exposed to a very small amount of radiation when you get a mammogram, a number of large studies show that the benefits of getting regular mammograms far outweigh the risks for most people. In addition, breast radiologists and other breast cancer experts say that ultrasounds should never be considered a replacement or substitute for mammograms. Ultrasounds should always be used in addition to mammograms (and in some cases, breast MRIs), because some breast cancers (for example, some stage 0 breast cancers) are less likely to be detected using ultrasound alone.