October 2021

The Advisory Committee on Medical Imaging (ACMI) has identified concerns regarding the performance of breast ultrasound in the province.

1. Breast ultrasound is a very operator-dependent examination and is not suitable for point-of-care examinations or diagnostic studies by sonographers or sonologists without suitable training. Ultrasounds performed by non-breast imagers may lead to significant delays in diagnosis for breast cancer.

    

2. Breast ultrasound should only be performed with mammographic facilities available, and in conjunction with mammograms, where necessary.  The exception is patients less than 30 years old with a palpable mass very much more likely to be a benign entity (such as a cyst or fibroadenoma) rather than a malignancy.

All patients with clinically suspected breast pathology should be referred to a facility with CAR accreditation for breast imaging (both breast ultrasound and mammography).  This is in the best interest of quality patient care, both in terms of not having to attend two different appointments, but also in having a unified interpretation of two modalities.