Mammogram or Ultrasound? What Women Should Know
When it comes to breast health, women have more imaging options than ever before. But with more options can come more questions: Do I need a mammogram? Should I also have an ultrasound? Can an ultrasound replace a mammogram?
For most women who are due for routine breast cancer screening, a mammogram is the standard and is the recommended form of imaging. In certain circumstances, a breast ultrasound may be recommended as an additional test — not a replacement. If patients only get a breast ultrasound, up to 75% of breast cancers will be missed. It’s important to talk with your healthcare provider about when you should begin screening and the types of imaging you need, but here are a few basic pieces of information to help understand the difference between a mammogram and an ultrasound and when they should be used.
What Is a Mammogram?
Mammograms are used to examine the breast using low-energy X-rays. The goal for mammography is the early detection of breast cancer by briefly compressing the breast between two plates while images are taken. Mammography is the primary imaging test used for routine breast cancer screening because it can detect changes in the breast — including some cancers — before they can be felt or cause symptoms. Early detection improves outcomes significantly.
Types of Mammograms
There are two types of mammograms.
Screening mammograms are used to look for signs of breast cancer in women who don’t have any breast symptoms or problems. X-ray images of each breast are taken, typically from two different angles. It’s important to get screened before you have symptoms.
Diagnostic mammograms are used to look at a person’s breast if they have symptoms or if a screening mammogram shows something unusual. They might include extra images of the breast. Sometimes diagnostic mammograms are used for people who were treated for breast cancer in the past.
What Is Breast Ultrasound?
Breast ultrasound uses sound waves to generate images of breast tissue. It can be particularly useful for evaluating a specific area of concern after a mammogram has already been taken.
Breast ultrasound can be used as supplemental screening in certain women, including some women with dense breast tissue, which may be recommended following a mammogram. It’s important to note that ultrasound should never replace a mammogram, even if a person has dense breast tissue.
Can I Get an Ultrasound Instead of a Mammogram?
No. An ultrasound is not a substitute for a mammogram. If patients only get a breast ultrasound, up to 75% of breast cancers will be missed.
Your healthcare provider may recommend that you receive an ultrasound in addition to a mammogram because the two tests can work together to create a more complete picture if it’s needed. One particularly important advantage of mammography is its ability to detect microcalcifications — tiny calcium deposits that can sometimes be an early sign of breast cancer. These findings may not be visible on ultrasound.
An ultrasound without a mammogram is not a complete picture of the breast. An ultrasound should never replace an annual screening mammogram. The Radiological Society of North America says that mammography is the only breast cancer screening tool known to reduce breast cancer deaths.
It’s also critical to note that not all facilities, especially mobile facilities that travel from place to place, are accredited by the American College of Radiology (ACR), which holds the highest standards in imaging. Some facilities have equipment that is accredited by ACR, but the facility may not be accredited, which is problematic. Patients should only visit facilities that are accredited, which can be looked up on the ACR website with a simple search tool.
If Mammograms Use Radiation, Are Ultrasounds Safer?
The dose of radiation used for a screening mammogram of both breasts is extremely low. Radiation can be measured in millisieverts (mSv), and the average dose for a typical mammogram with 2 views of each breast is about 0.4 mSv. That’s about the same amount of radiation a person would get from normal, everyday life over 1 to 2 months. The benefits of a mammogram significantly outweigh such a low-energy X-ray.
Is There A More Comfortable Option Than a Traditional Mammogram?
Yes. An option for a more comfortable mammogram is the SmartCurve System. The system provides a curved compression surface that offers a more comfortable patient experience without compromising image quality, exam time, or X-ray dose. Clinically proven to deliver a more comfortable mammogram, the SmartCurve system improves comfort in 93% of patients who reported moderate to severe discomfort with standard compression.
If I Have Dense Breasts, Do I Still Need A Mammogram?
Yes. Having dense breasts does not mean that mammography stops being useful. In fact, the American Cancer Society (ACS) specifically advises women with dense breasts to continue receiving regular mammograms. The ACS says that most breast cancers can be seen on a mammogram even for those with dense breast tissue, and it advises patients to speak with their provider about considering any additional screening tests in addition to mammograms.
How Can I Get a Mammogram?
Speak with your healthcare provider about scheduling a mammogram. If you can’t schedule an appointment or need scheduling flexibility, Independence Health System hosts Walk-In Wednesdays for mammograms. At select locations on Wednesdays, patients can walk in without a script or an appointment and receive a mammogram. Visit the website for locations and hours.
How to Best Protect Yourself
If you are due for a mammogram, schedule it, or find a walk in location. Do not rely on an ultrasound by itself. If you’re not sure of the next step, talk to your healthcare provider. If you have dense breasts or questions about whether you could benefit from additional imaging, talk with your healthcare provider. The goal isn't to have more tests. It's to have the right tests for you.
