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reasons why a lump would not be detected on ultrasound?
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reasons why a lump would not be detected on ultrasound?

As I have been reading here for the past few weeks, it appears that several ladies have breast lumps that are not being picked up on an ultrasound.  I am also included in this, as my lump which is fairly superficial  on the underside of the breast and about 1/2" in size was not seen in the mammogram or ultrasound.

If an ultrasound is supposed to be a good test for those of us with dense breasts, why is it not picking up some of these lumps?  
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Avatar_n_tn
Hi.

There are actually several reasons why some lumps are not seen on ultrasound. One of them is that the lumps are isodense with the surrounding tissue, thus would appear on ultrasound like normal breast tissue. Another reason is that not all types of breast cancers are visible on ultrasound. One more reason is that calcifications of breast cancer seen on mammography are not picked up by ultrasound. Finally, ultrasound has a low threshold which leads to it picking up a lot when there is actually nothing there.

Hope this answers your query.
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Avatar_n_tn
Are there any benign reasons why a lump would not be detected?

I also do have breast implants and have had them for 8 or so years.  

My mammogram was normal with no masses detected or calcifications.  I was given a birad score of 1.

I have had pain in that area of the breast on and off for 3 years and never actually felt a lump until last month.  Because of my age (30's) none of my doctors ever seemed too concerned about the pain. The painful lump is persistant now, but does fluctuate in intensity, although not with my menstral cycle.

To make matters worse, in the last few weeks I began having pain in and around my shoulder blades and upper spine.  I do have multiple sclerosis, so perhaps the stress triggered some new MS symptoms.  But I can't help but think I might have cancer that has spread to the spine.

How likely does it seem that my lump may turn out malignant, given a birad 1 although it was not detected?

If I have scar tissue from the breast implants, would that be seen on an ultrasound?

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Avatar_n_tn
Hi.

Unless a biopsy for the breast lump is done, there is no absolute certainty that it would turn out to be malignant. However, a BIRADS score of 1 does necessitate routine screening so any changes can be detected on the next exam.

Scar tissue may or may not be seen on ultrasound and would depend on the density of the surrounding tissue.
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