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Is a Breast Ultrasound or Mammogram Better?

Medically Reviewed on 5/8/2025
Disease and Condition: Breast Cancer (Facts, Stages)

What are breast ultrasounds and mammograms?

ultrasound vs mammogram
A breast ultrasound is more accurate in younger women, whereas a mammogram is preferred in older women.

An ultrasound uses high-frequency sound waves on the breast and converts them into images. Mammography uses low-dose X-rays to produce breast images known as a mammogram.

As a rule of thumb, a breast ultrasound is more accurate in women younger than 45 years. Mammography is preferred in women older than 45 years. Therefore, the investigation best suited to you depends on your age, your symptoms, and the structure of your breasts.

Often, for women with dense breasts or those with a history of scarred tissues in the breast, a sonography is a better option than a mammography. Your doctor may supplement your mammography with sonography or vice versa to be sure of any lump in the breast.

Advantages and disadvantages of ultrasound and mammogram

Physicians will never advise replacing a mammogram with an ultrasound. It is always better to use both tests. Mammograms are the most common screening tool in the United States and other developed countries. However, in developing countries, women might not have access to a mammogram or may not be able to afford it. Hence, an ultrasound would be the most feasible option in such countries.

Where a mammography is available, an ultrasound should be a supplemental test. An ultrasound should be done for women with dense breasts who do not meet high-risk criteria for magnetic resonance imaging (MRI) screening. Moreover, it should be done for high-risk women with dense breasts who are unable to tolerate an MRI.

Table. Advantages and disadvantages of ultrasound and mammography
Mammogram Ultrasound
Advantages
  • Best screening tool for breast cancer
  • Not dependent on the operator
  • Detects calcifications, distortions, and asymmetry in the breast
  • Detects small tumors
  • Detects early tumors
  • Death rates have been on the decline when used for screening
  • Painless procedure
  • Easy to use
  • Cheaper and portable
  • Easily accessible in developing countries
  • Detects lesions in women with dense breasts, which are not visible on a mammogram
  • No radiation involved
  • Can be used safely in pregnant women
Disadvantages

Some of the disadvantages of mammograms include:

  • Exposure to radiation and risk of cancer
  • Less effective in women with dense breasts, which contain more glandular and connective tissue than fat
  • Overdiagnosis
  • Expensive
  • Less accessible in many parts of the world
  • It cannot be used in pregnant women

Disadvantages of an ultrasound include:

  • Accuracy depends on the skill of an operator unless automated
  • Less adept at detecting calcifications
  • Higher rate of false positives
  • Additional procedures are required for interpretation

QUESTION

A lump in the breast is almost always cancer. See Answer

Who should consider breast cancer screening?

Breast cancer is the second leading cause of death in American women. It is cancer that starts in the tissue of the breast. Breast cancer mainly affects the tube that carries milk to the nipple (ducts) and glands that make milk (lobules).

Some of the risk factors associated with breast cancer include:

  • Increasing age
  • A family history of the disease on the mother's side
  • A known BRCA1 or BRCA2 mutation
  • Menarche at an early age
  • Late pregnancy or never having given birth
  • Not breastfeeding the child
  • Use of hormones such as estrogen and progesterone
  • Obesity
  • Consumption of alcoholic beverages

Those women are at a high risk of breast cancer who have:

  • A known BRCA1 or BRCA2 mutation.
  • A family history of breast cancer.
  • Had radiation therapy to the chest when they were between the ages of 10 and 30 years.
  • An ongoing genetic disease, such as Li-Fraumeni syndrome, Cowden syndrome, or hereditary diffuse gastric cancer.
  • A personal history of breast cancer.

Health News

Medically Reviewed on 5/8/2025
References
https://www.cityofhope.org/breast-ultrasound-better-screening-for-more-women

https://www.breastcancer.org/research-news/ultrasound-may-be-alternative-to-mammo

https://www.radiologyinfo.org/en/info.cfm?pg=screening-breast

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