Many women wonder whether breast ultrasound or mammogram is the better choice for breast cancer screening. The truth is, these tests aren’t meant to replace one another—they work best together. When combined, mammograms and breast ultrasounds can increase cancer detection rates by up to 96% in women with dense breast tissue, offering a more complete picture of breast health. Using both tools provides a comprehensive approach to early detection.
The reason is that it prevents deaths from breast cancer. Between 1975 and 2019, breast cancer deaths dropped 58%. This was due to a combination of screening mammography and improvements in treatment.
Today, the average woman has about a 12% lifetime risk of developing breast cancer—roughly one in eight women. Excluding skin cancer, breast cancer is the most common type of cancer in women today. One out of every three cancers diagnosed today is breast cancer. This is why comprehensive screening is so critical.
When it comes to breast cancer screening, most women immediately picture mammograms. But the truth is that there isn’t just one tool that does it all. Mammograms and ultrasounds work in different ways—and both can be powerful in detecting tumors early. Often, they are combined to increase breast cancer detection rates.
One of the essential breast cancer facts every woman should know is that there isn't just one single tool for detecting tumors. Breast ultrasound and mammography are two different methods for breast cancer screening.
Your family history, individual risk factors, and past experiences with mammograms can all help to determine the best test for you.
Here’s a comparison and why your healthcare provider might recommend one over the other.
During a mammogram, breasts are flattened between two surfaces to thin out tissue and capture digital imagery. The images are then reviewed by a specialized doctor called a radiologist. If an area of concern is identified, a diagnostic ultrasound may be necessary.
Types:
Mammogram + a screening ultrasound may be the best screening option.
Mammograms are routine. They should be a part of the routine age-based or risk-based health screening that you have with your care provider. The American Cancer Society recommends the following:
If findings on your mammogram require clarification, your healthcare provider may order a diagnostic breast ultrasound. However, you can order a screening breast ultrasound (without a doctor’s referral) at any age. Here are some instances where you might also want to have a breast ultrasound:
Breast lumps aren't uncommon. In many cases, lumps may be benign, fluid-filled masses that only require further monitoring. However, the development of a new lump or change to an existing lump must be addressed with a care provider.
What do breast lumps feel like? Common types include:
Skipping straight to an ultrasound for a breast cancer diagnosis is not necessarily recommended for every woman. In certain situations, you may be a candidate who would benefit from a supplemental ultrasound, even if you have no signs of breast cancer.
Here are some cases where a woman may be a candidate for both a screening mammogram and a screening ultrasound.
According to HerScan’s lead sonographer Heather Johnson “asymptomatic individuals with dense breast tissue may benefit from adding screening breast ultrasound to their breast health regimen.”
Roughly 50% of women have dense breast tissue. An ultrasound may be able to detect cancers that would remain hidden by thick breast tissue during an ordinary mammogram. On a mammogram, dense tissue appears similar to white cancerous tumors. As a result, it can be nearly impossible to distinguish a tumor from other tissue. A study found that the sensitivity of a mammogram drops from 85% to just 48% to 64% in women with dense breasts.
Johnson says, “Because no imaging modality is perfect, it can be helpful to combine both mammography and breast ultrasound in individuals with dense breast tissue.” She goes on to explain, “Mammography is excellent at identifying microcalcifications, even in the most dense tissue. The sensitivity of a mammogram identifying masses within dense tissue, however, is limited.”
Ultrasound screening is also recommended whenever there's a genetic or family risk factor involved. For women with BRCA mutations or other risk factors, ultrasound offers an extra layer of reassurance.
Johnson says “symptomatic individuals can benefit from ultrasound, but they are best served with a diagnostic breast ultrasound, not a screening breast ultrasound.”
Johnson explains how this works: “The sound waves used in ultrasound and the x-rays in a mammogram do not act the same in dense tissue. When x-rays from a mammogram reach dense tissue, they stop and make the image look white. The same thing happens when x-rays from a mammogram reach a mass - they stop and show up white on the image.”
“Masses that appear white on an image can be very challenging, sometimes impossible to see when situated within dense tissue that also shows up white. The sound waves from an ultrasound, on the other hand, do not stop when they reach dense tissue. This means that we can see from the skin, all the way to the chest wall. That coupled with ultrasound's ability to characterize masses both within dense tissue (aka fibroglandular tissue) and fatty tissue make it a great complementary exam to mammography.”
Johnson says that “everyone is unique. Talk to your provider to determine if you have dense breast tissue and if your unique situation could benefit from supplemental screening breast ultrasound.”
According to Johnson, HerScan is a “convenient, inexpensive option for breast screening ultrasound.”
At HerScan, we offer advanced mobile breast ultrasound screenings. They are compression-free, quick, and comfortable. Our ultrasound appointments generally last just 20 minutes.
After the test, the images are reviewed by board-certified radiologists. If you have dense breast tissue or an increased genetic risk, don’t wait; schedule your appointment today.
Early detection is everything in the fight against cancer. We encourage women to stay informed and take charge of their healthcare by adding a powerful Breast Ultrasound to their breast healthcare regimen. To schedule an appointment at your convenience, please click here.