Challenges in Interpretation of US Breast Findings in the Emergency Setting

Emergencies in breast imaging are infrequent but not rare. Although infectious conditions such as mastitis and breast abscess are the most common breast diseases encountered in acute care settings, other entities that may require additional imaging or different treatment approaches are also seen and include traumatic injury and breast cancer. While mammography is widely available for breast evaluation in outpatient facilities, most emergency departments do not have mammography units. This makes evaluation of patients with breast disease incomplete in the acute care setting and emphasizes the role of appropriate US techniques for interpretation. It also highlights the importance of effective sonographer-to-radiologist communication to ensure patient safety and diagnostic accuracy, especially in an era of increasing adoption of teleradiology. The authors discuss the challenges in image acquisition and remote interpretation that are commonly faced by radiologists when they assess breast anomalies in the emergency setting. They present strategies to overcome these challenges by describing techniques for proper US evaluation, highlighting the importance of sonographer-radiologist communication, defining the goals of the evaluation, reviewing common differential diagnoses, and providing appropriate follow-up recommendations. ^©RSNA, 2023 Quiz questions for this article are available in the supplemental material.