Finding a new lump on your body can be a source of worry, prompting many to seek medical evaluation. Medical imaging, particularly ultrasound, plays an important role in the initial assessment of such findings. Ultrasound uses high-frequency sound waves to create real-time images of internal body structures. This non-invasive technique is valuable for examining lumps and guiding diagnosis.
How Ultrasound Evaluates Lumps
When evaluating a lump, medical professionals look for several characteristics on an ultrasound image. Shape is one feature: benign (non-cancerous) masses often appear round or oval with smooth margins, while malignant (cancerous) lumps tend to be irregular with ill-defined or spiky borders. Internal structure differentiates fluid-filled cysts (dark, anechoic) from solid masses (denser, irregular echoes).
Echogenicity, or how tissue reflects sound waves, varies; cancerous lumps often appear darker (hypoechoic) than surrounding healthy tissue. Doppler ultrasound assesses vascularity, revealing blood flow patterns; increased or chaotic flow within a lump can suggest malignancy due to rapid cancer cell growth. Compressibility and mobility are also observed; benign lumps are softer and more mobile, while malignant ones are rigid and fixed due to tissue invasion.
Why Ultrasound Alone Isn’t Definitive
While ultrasound provides valuable information about a lump’s characteristics, it cannot definitively diagnose cancer. Features like irregular shape or increased vascularity can suggest malignancy, but similar appearances occur in benign conditions. This overlap means ultrasound is an interpretative tool, and its findings are not always conclusive.
Ultrasound images show a lump’s physical structure, not its cellular composition. A definitive cancer diagnosis requires microscopic examination of tissue cells. Therefore, while ultrasound helps identify suspicious areas, it is not a standalone confirmatory test for cancer.
The Path to Diagnosis
Since ultrasound alone cannot definitively confirm cancer, further steps establish a precise diagnosis. The gold standard is a biopsy, which removes a small tissue or cell sample for laboratory analysis. A pathologist, a doctor specializing in examining tissues, then studies the sample under a microscope to determine the cancer type and its aggressiveness.
Several biopsy types exist, including fine-needle aspiration (FNA), where a thin needle extracts fluid and cells, and core needle biopsy, which uses a larger needle to obtain a tissue cylinder. Surgical biopsies, such as incisional (removing part of the lump) or excisional (removing the entire lump), may also be performed if other methods are inconclusive. Ultrasound often guides these biopsy needles precisely into the suspicious area, improving accuracy and reducing complications. In some cases with clearly benign findings, a healthcare professional might recommend watchful waiting and follow-up imaging rather than an immediate biopsy.