If a patient has dense breasts, the answer is yes. In several large studies [1-4], including the ASTOUND  prospective multicenter trial in Italy, ultrasound significantly improved detection of cancer even after tomosynthesis (3D mammography) or the combination of 2D and 3D mammography in women with dense breasts. A 2020 prospective multicenter study  of abbreviated (“fast” or “mini”) MRI in 1444 women with dense breasts found an overall 3D mammography cancer detection rate of 6.2/1000 women screened vs. an overall abbreviated MRI cancer detection rate of 15.2/1000, a difference of 9/1000. If a patient has been recommended to have MRI screening because of her risk factors, she would still have MRI even if tomosynthesis is performed, regardless of her breast density. If screening MRI is performed, then screening ultrasound is not needed.
1. Tagliafico AS, Calabrese M, Mariscotti G, et al. Adjunct screening with tomosynthesis or ultrasound in mammography-negative dense breasts (ASTOUND): Interim report of a prospective comparative trial. J Clin Oncol 2016
2. Tagliafico AS, Mariscotti G, Valdora F, et al. A prospective comparative trial of adjunct screening with tomosynthesis or ultrasound in women with mammography-negative dense breasts (ASTOUND-2). Eur J Cancer 2018; 104:39-46
3. Destounis S, Arieno A, Morgan R. Comparison of cancers detected by screening ultrasound and digital breast tomosynthesis. Abstract 3162. In: American Roentgen Ray Society (ARRS). New Orleans, LA, 2017
4. Dibble EH, Singer TM, Jimoh N, Baird GL, Lourenco AP. Dense breast ultrasound screening after digital mammography versus after digital breast tomosynthesis. AJR Am J Roentgenol 2019; 213:1397-1402
5. Comstock CE, Gatsonis C, Newstead GM, et al. Comparison of abbreviated breast MRI vs digital breast tomosynthesis for breast cancer detection among women with dense breasts undergoing screening. Jama 2020; 323:746-756