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Mammogram vs. ultrasound for early breast cancer detection

Key takeaways:

  • Regular mammograms are the best way to catch breast cancer early. When the screening method shows abnormalities, an oncologist can prescribe an ultrasound to confirm the findings. 
  • Generally, mammograms are suitable for women older than 45 and can detect tiny tumors in less dense breasts.
  • Breast ultrasounds are prescribed for women with dense breasts younger than 45 and those who can’t have X-rays. 
  • A mammogram uses low-dose radiation X-rays, while a breast ultrasound uses high-frequency sound waves.

By the end of 2020, 7.8 million women diagnosed with breast cancer in the previous five years have survived. Based on this statistic, the World Health Organization (WHO) says that breast cancer has become the world’s most prevalent cancer. 

The WHO aims to lower cancer mortality rates by 2.5% per year. That can help avoid 2.5 million breast cancer deaths between 2020 and 2040. However, early breast cancer screening is key to achieving that goal. 

Thankfully, with scanning centers and popular screening tools such as breast ultrasounds, mammograms, and breast MRIs (magnetic resonance imaging), you can gain access to regular early detection. 

In this article, we’ll look at a mammogram vs. ultrasound for breast cancer screenings. 

What is a mammogram?

mammogram vs ultrasound: old woman smiling

Mammography is a breast imaging procedure that gives an X-ray image of your breasts. Regular mammograms are the best way for your oncologist to find breast cancer at an early stage.

Sometimes, a mammogram can help detect breast cancer up to three years before you feel a cyst, lesion, or any abnormal change in your breast tissue. 

During a 2D mammogram, you’ll stand in front of a special X-ray machine. Your radiologist will place your breast on a plastic plate while another plate will firmly press your breast from above. These plates flatten the breast and keep it still while taking the X-ray. After getting the top and bottom X-rays of your breast, your radiologist will take the side view as well. It’s common to feel some pressure during a mammogram. 

A 3D mammogram follows this procedure—except that instead of creating only four images from two angles, 3D mammography produces several images from all possible angles to create a three-dimensional model of your breast. 

Again, the mammography procedure occurs in two phases—a screening mammography and a diagnostic mammography.  

In the former, your oncologist tries to detect breast changes in women without symptoms or new breast abnormalities. And with a diagnostic mammogram, your oncologist investigates the suspicious breast changes.  

What is an ultrasound?

Ultrasound screening is commonly used to study a developing fetus, heart and blood vessels,  muscles, and tendons, and abdominal and pelvic organs. Beyond that, your radiologist would recommend an ultrasound scan when you get an abnormal mammogram. 

The ultrasound uses high-frequency sound waves to look for tumors in the breast when they don’t show up on X-rays (American Cancer Society). 

In a breast ultrasound scan, your healthcare provider moves a wand-like device called a transducer over your breasts to get their images. The transducer sends high-frequency sound waves (too high-pitched and inaudible for you) that bounce off your breast tissue. It then picks up the bounced sound waves to develop pictures of the inside of your breasts.  

The key differences: Mammogram vs ultrasound.

By now, you have a fair idea of a mammogram vs. ultrasound. Let’s now see the differences in imaging methods and usage cases.

Imaging mode.

Mammograms use X-rays (low-dose radiation), while ultrasound uses sound waves.

Image accuracy.

Microcalcifications (small calcium deposits) can be early signs of breast cancer. Breast ultrasounds don’t detect these.

For women younger than 45 years, a breast ultrasound might work. However, for women older than 60, mammography is preferred (Journal of the Association of Basic Medical Sciences).

On the other hand, mammograms do not work well with high breast density, which is more common with younger women, those aging 44 ± 7 years

Purpose.

A breast ultrasound or a diagnostic mammogram may be used after an abnormal mammogram. It can also guide a health practitioner through a breast biopsy.

Who should get a mammogram vs. ultrasound?

mammogram vs ultrasound: family sitting on the couch

You should consult your healthcare practitioner about which screening method is right for you. However, some women will need to closely review their options due to a few factors: 

Risk factors.

A mammogram is especially important for older women, women with a family history of breast cancer, and women with any other risk factors.

Breast tissue density.

If you have dense breast tissue, it can be hard for a mammogram to detect cancer. At this point, your oncologist would order an ultrasound. However, if you are obese or have large breasts, you might not get accurate images from a breast ultrasound—a mammogram is best. This is because the ultrasound wave signals find it difficult to penetrate the dense breast tissue to picture what’s underneath. 

When should you begin screening for breast cancer?

The American Cancer Society offers these recommendations for regular breast cancer screenings:

Between ages 40 to 44: If you wish, you can start having annual mammograms. 

Between ages 45 to 54: You must get annual mammograms. 

55 years and older: You can continue yearly screening or switch to mammograms every two years.

However, if you find breast lumps or some other abnormality, don’t wait for your annual appointment. Book an mammogram appointment through Ezra. 

You can also take Ezra’s five-minute assessment to learn more about your risk for breast cancer. 

How to prepare for a mammogram.

woman smiling

Here are a few tips on how you could prepare for your mammogram screening. 

  • First, choose a certified mammography facility
  • Book your appointment when your breasts won’t be tender. Generally, if you aren’t yet through menopause, your breasts are tender during and before your menstrual week.
  • If you have undergone mammography before at another facility, bring those mammograms. 
  • Don’t use powders, deodorants, creams, and other cosmetics the day of your mammogram. They could confuse the image interpretation.
  • To ease the discomfort during the procedure, you can take an over-the-counter medication like aspirin or Tylenol. 

Protect your health today.

Regular mammograms are usually the best way to detect breast cancer early.

More than a third of women who are eligible for a screening breast mammogram don’t book them. Our research shows that’s because booking mammograms just aren’t easily accessible and convenient to book. That’s why we’ve launched the Ezra Mammogram

Now available at our New York partner facilities (and soon available at our California locations), our service allows you to book your appointment online with openings as early as next week. Our mammograms are insurance-covered for women aged 40 or over (who have insurance), or $325 for self-pay. Plus, your 3D mammogram will take only 20 minutes, and your results will be available in just 48 hours.