Real-time breast US is useful in the evaluation of localized lesions. Our study was aimed at examining the US features of the ductolobular system in physiological condition. To this purpose, all breasts were imaged on the radial plane by rotating the probe around the nipple, thus depicting the ductal system from nipple to gland periphery. The patients were made to lie supine or to sit down. In order to depict small lobular excrescences, TV magnification was employed on the target areas. Five hundred and twenty asymptomatic women were evaluated with US; preliminary mammograms had been obtained in 440 of them. Any subject with prominent duct shadows on mammography or mammographic and/or US demonstration of focal lesions was excluded from the study. Different US patterns were observed in the ductolobular system, depending on patients' age, mammographic patterns, physiological hyperplasia during pregnancy and/or involution after pregnancy and lactation. The ductal branches were demonstrated by US only in mammographically dense areas. Thus, US has been observed to allow the evaluation of the physiological changes in the ductolobular system.
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