Critical Thinking for Sonographic Breast Imaging

Sonography of the breast has become invaluable in the characterization of breast lesions identified on mammography or at physical examination. The ability of sonographers and sonologists to employ critical thinking skills when imaging breast lesions is an important aspect to correctly diagnose and follow breast pathology. The purpose of this article is to delineate this process and provide examples of each sonographic categorization that these masses might present with. With careful attention to what can and should be documented with every breast lesion found by sonography, consistency to clinical and surgical treatment may increase. Keywords BI-RADS, breast cancer, breast sonography, breast lesions, breast imaging lexicon, breast masses Critical thinking is the identification and evaluation of evidence to guide decision making. A critical thinker uses broad in-depth analysis of evidence to make decisions and communicate his or her beliefs clearly and accurately.1 Breast cancer is one of the most common malignant tumors and holds a high incidence of cancer-related mortality among women.2,3 Breast sonography has proven to be a popular supplement to mammography in the identification and characterization of lesions. Breast sonograms provide the interpreting physician with additional information that helps to confirm the findings of other mutually comple-mentary diagnostic imaging examinations, such as mam-mography and magnetic resonance imaging (MRI), as well as holds the ability to identify clinical areas of suspicion. As breast sonography became a necessary adjunct or stand-alone examination in breast imaging, the need for defining sonographic characteristics rapidly became evident. Although many articles and books have been written on this great topic, this article aims to describe the necessary elements that every breast lesion should be evaluated for in an attempt to provide consistent reporting and documen-tation for every patient undergoing a breast sonogram