Ultrasound should NOT be considered a replacement or substitute for mammography, as many breast cancers (about half of DCIS, seen most often as calcifications, and one in four to five invasive breast cancers) may only be depicted on mammography/tomosynthesis, even in women with dense breasts. Ultrasound screening should only be done as an adjunct to screening mammography in patients with dense breast tissue.
Women who refuse mammography based on concerns about radiation or other factors (for example, pain/discomfort from compression) should be counseled on the safety of mammography, the low risks of the radiation associated with mammography, and the success of mammography as a screening test. Many centers will not perform screening ultrasound without a screening mammogram/tomosynthesis.
However, in some uncommon situations, ultrasound may be performed as the primary test for screening if the center has the required expertise:
- The most common situation for using ultrasound as a primary screening tool would be in young patients (under age 30) who are at high risk for developing breast cancer but who are unable to have breast MRI due to pregnancy or other factors.
- Women for whom mammography cannot be performed for any reason may benefit from ultrasound screening, such as women over age 40 with disability impacting the ability to cooperate with mammographic positioning.
In women at elevated risk of breast cancer who cannot have MRI due to implanted devices, claustrophobia, allergy to contrast (gadolinium chelate), or body habitus precluding positioning, ultrasound screening can also be used as a supplement to mammography.Browse All Provider FAQ's