Mammogram & Breast Ultrasound
The dual approach to breast health. While mammography remains the gold standard, adding ultrasound is often critical for women with dense breast tissue to ensure nothing is missed.
Key facts at a glance
Why two tests are often better than one.
The "Dense Breast" Dilemma
On a mammogram, fat looks dark and cancer looks white. Dense breast tissue also looks white. This can hide tumors like a "polar bear in a snowstorm." Ultrasound sees through density differently, making tumors stand out as dark spots against the white tissue.
Who needs supplemental screening?
- Women notified they have "heterogeneously dense" or "extremely dense" breasts (BI-RADS C or D).
- Women with a strong family history or genetic risk (BRCA).
- Anyone who wants the highest sensitivity screen available.
The Technologies
- Mammogram (Tomosynthesis): 3D X-ray. Excellent at finding micro-calcifications (often the earliest sign of cancer) and distortions.
- Ultrasound: Uses sound waves. Excellent at distinguishing fluid-filled cysts (benign) from solid masses (suspicious), and seeing through dense tissue.
When to start?
Guidelines vary globally. Many experts recommend starting annual screening at age 40 to maximize life-saving potential. If you have a family history, screening often starts 10 years before the age your relative was diagnosed.
References
Guidelines and studies.
- ACR Appropriateness Criteria® Breast Cancer Screening — American College of Radiology (2023)
- Melnikow J, et al.. Supplemental Screening for Breast Cancer in Women With Dense Breasts — Annals of Internal Medicine (2016)
- Vacek PM, et al.. A prospective study of breast density and breast cancer risk — Cancer Epidemiology (2003)View source — Discusses increased risk associated with dense tissue
Content is educational and not medical advice. For personal recommendations, consult your clinician.