Longitudinal and transverse scan planes can be acceptable for a generalized search of a region and for specifically scanning simple and complex breast cysts. However, demonstrating normal ductal anatomy requires scanning in the radial scan planes because the normal mammary ducts are generally radially oriented away from the nipple. Scanning the breast along normal anatomic-lobal planes also assists in recognizing the mass's path and origin, which helps to narrow the differential diagnosis.

Longitudinal and transverse: The breast may be surveyed using a back-and-forth motion in each quadrant. These planes are not parallel to the long axis of the underlying lobar anatomy, making interpreting findings more difficult.  If this survey style is used, the scan plane should be adjusted to radial and antiradial planes as soon as pathology is identified.

Radial and antiradial (The ideal survey pattern): Scanning the breast in an antiradial plane from the outer edge to the central path/nipple, minimizes tissue wrinkles, consistently keeping Cooper’s ligaments under tension, resulting in a more efficient interrogation of the tissue. All positive findings must be documented in radial and antiradial planes; obtaining clips is highly beneficial for reading radiologists to achieve the most accurate diagnoses.

The most crucial factor is to ensure you've scanned all the tissue in perpendicular planes. If you do not scan perpendicular, you risk missing something, especially something small.

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