Ultrasound can usually give doctors a better look at a mass than mammograms, but it is reserved for suspicious findings on physical exam or mammogram. Certain features on the ultrasound can increase or decrease the suspicion that a mass is cancerous. If an ultrasound comes out with suspicious findings, only a biopsy (or sample of the tissue) can truly confirm the presence of cancer.
In my case a cyst was clear, but my tumor was solid on the ultrasound. When the doctor said the mass was solid I just knew. Anyway that is one of the ways they can decide if a biopsy is needed or not.1
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