Mammogram vs. Breast Ultrasound

an ultrasound technician reviews a breast ultrasound

Both mammograms and breast ultrasounds are commonly used to detect breast cancer in women. However, mammograms still remain the primary diagnostic tool for detecting breast cancer in women who do not yet exhibit any signs or symptoms of the disease.

Since breast ultrasounds are not nearly as painful as mammograms, many women wonder if breast ultrasounds could replace mammograms as the primary screening tool for breast cancer.

What’s the difference?

Mammogram screening exams involve using low-dose x-rays to take pictures of each breast. The radiologist will then evaluate each image and compare with previous images to determine if there are any abnormalities in the breasts that may indicate the early stages of breast cancer. Mammograms work by compressing the breasts for a few seconds in order to flatten and spread the tissue so that even small abnormalities will be visible.

Breast ultrasounds are typically recommended for women who have already undergone mammogram screening and abnormalities were detected. Ultrasounds involve using high-speed sound waves to create images of the tissues inside the body. Breast ultrasounds require using a handheld probe to move across each breast to assess specific areas of concern.

Which is better for diagnosing breast cancer?

While mammograms and breast ultrasounds are both useful tools for diagnosing breast cancer, there are benefits and drawbacks to both methods of testing. Benefits include:

  • Benefits of a Mammogram
    Mammograms are able to detect microcalcifications, which are tiny dots of calcifications that are usually indicative of breast cancer. Since mammograms are better at picking up the earliest signs of breast cancer, your treatment is likely to be more successful.
  • Benefits of a Breast Ultrasound
    Ultrasounds are virtually painless when compared to the extreme discomfort of mammograms. Additionally, according to a recent study in Australia, ultrasounds are more effective at detecting cancer in women who are already experiencing symptoms, especially in younger women.

Here are some of the risks of each method of testing:

  • Risks of a Mammogram
    Mammograms are not as effective in younger women who have denser breast tissue, which can confuse the results of the exam. Additionally, mammograms use low doses of radiation which can be potentially harmful. Finally, mammograms are not always accurate and may produce false negatives or false positives for breast abnormalities.
  • Risks of a Breast Ultrasound
    Ultrasounds are unable to detect small abnormalities that represent the earliest stages of breast cancer. Additionally, ultrasounds are heavily operator dependent, which means if the technician does not hold the probe correctly, then it is very easy to miss something that may be important.

Is there a clear winner when it comes to screening?

In conclusion, using ultrasound instead of mammogram screening exams for early detection of breast cancer is currently not a viable option. In part, this is because there are currently not enough well-trained breast ultrasonographers in the country for an ultrasound to be used as a screening test. Though mammography is far from a perfect option, it is still the best one we currently have available. However, for women who are already experiencing symptoms of breast cancer, an ultrasound along with a mammogram are both very good diagnostic tools.