Table of ContentsView AllTable of ContentsPurposeHow They WorkImage QualityLimitationsWhich Is Best?Other OptionsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Purpose
How They Work
Image Quality
Limitations
Which Is Best?
Other Options
Frequently Asked Questions
A breast ultrasound orsonogramis not the same as a mammogram. Both are imaging tests that can be used to look forbreast cancer. A mammogram is the gold standard for breast cancer detection, but a breast ultrasound is a complementary test that can help identify specificchanges in the breast.
Since each test complements the other, healthcare providers may use breast ultrasounds with mammograms for breast cancer screening and diagnosis.
This article reviews the differences between breast ultrasounds and mammograms. You will learn about the benefits, limitations, and risks of each type of imaging test as well as other options for diagnosing breast cancer.
Verywell / JR Bee
What Is a Mammogram Used For?
Purpose of Breast Ultrasounds vs. Mammograms
Amammogram is anX-ray of the breasts. Mammograms are the most effective breast cancer screening test.
They can take multiple pictures of the breast and identifycalcifications(calcium deposits within breast tissue).In addition, mammograms are important for diagnosing and following up after breast cancer.
Abreast ultrasound or sonogramis generally used for diagnostic reasons. For example, an ultrasound is most helpful when evaluatingdense breastsora suspicious lump found on a mammogram.
Benign Lumps vs. Cancerous Breast Lumps
Breast Ultrasound vs. Mammograms: How They Work
A big difference between a mammogram and a breast ultrasound is how they work. Mammograms use low-dose radiation to X-ray the breasts, while ultrasounds use sound waves.
Does Mammogram Radiation Raise Breast Cancer Risk?
Breast Ultrasound vs. Mammogram: Image Quality
The quality of the images from a breast ultrasound and a mammogram are also different.
Recent studies suggest that people who have dense breasts could benefit from a mammogram plus fast breast magnetic resonance imaging (fast breast MRI). The combination of tests may produce fewerfalse positivesthan mammography and ultrasound alone.
In addition, fast breast MRI seems to be equal to conventional MRIs, which are the best test for finding breast cancer. Though they are good, they are expensive and usually only offered to high-risk patients. Since fast breast MRI testing is relatively new, it is not available at every facility that offers breast cancer screenings.
Limitations of Mammograms and Breast Ultrasounds
Both mammograms and breast ultrasounds have limitations. However, there are more limitations to breast ultrasounds.
Breast ultrasounds:
That said, mammograms and ultrasounds are both subject to user error. One study found that radiologists missed 10% to 30% of breast cancers seen on mammograms.Additionally, the operator’s skill level can significantly affect the accuracy of a breast ultrasound result.
How to Understand Your Mammogram BI-RADS Score
When Are Breast Ultrasounds Needed?
Mammogram remains the gold standard for breast cancer screening. The United States Preventive Services Task Force recommends that women at average risk of breast cancer get mammograms every other year beginning at age 40.
Breast ultrasounds are typically done as a complement or additional test after a mammogram. In people who have dense breast tissue, for example, an ultrasound can sometimes identify malignancies that aren’t visible on a mammogram image.
Ultrasound as an annual test (instead of a mammogram) is not currently recommended for people who aren’t at risk for breast cancer. This is because there isn’t enough evidence to prove that the benefits outweigh the harms.
For example, a breast ultrasound could be false positive, indicating that you may have cancer when you don’t. That means you might need to go back for a biopsy or other tests. If you don’t have cancer, these tests can cause unnecessary stress.
Comparisons
Ultrasounds and mammograms each have different strengths and weaknesses. You may need a breast ultrasound if your provider finds something unusual on your mammogram. For example, when your mammogram shows a lesion on your breast, an ultrasound can help determine if it is a cyst or a solid mass.
Mammogram vs. UltrasoundMammogramUses a small amount of radiationCan’t distinguish between a cyst and a solid massNot as good at spotting abnormalities in people with dense breast tissueGood at spotting calcificationsDifferent views can give the radiologist a look at the entire breastCan be used to find suspicious areas deeper inside the breastCan view the axillary lymph nodesTypically used for breast cancer screeningBreast UltrasoundDoes not use radiationCan help distinguish between solid masses and cystsBetter at spotting abnormalities in people with dense breast tissueMuch less effective at finding calcificationsCannot view the entire breastCannot view deep breast tissueCannot view the axillary lymph nodesTypically used for diagnosing abnormalities found during screening
Mammogram vs. Ultrasound
MammogramUses a small amount of radiationCan’t distinguish between a cyst and a solid massNot as good at spotting abnormalities in people with dense breast tissueGood at spotting calcificationsDifferent views can give the radiologist a look at the entire breastCan be used to find suspicious areas deeper inside the breastCan view the axillary lymph nodesTypically used for breast cancer screening
Uses a small amount of radiation
Can’t distinguish between a cyst and a solid mass
Not as good at spotting abnormalities in people with dense breast tissue
Good at spotting calcifications
Different views can give the radiologist a look at the entire breast
Can be used to find suspicious areas deeper inside the breast
Can view the axillary lymph nodes
Typically used for breast cancer screening
Breast UltrasoundDoes not use radiationCan help distinguish between solid masses and cystsBetter at spotting abnormalities in people with dense breast tissueMuch less effective at finding calcificationsCannot view the entire breastCannot view deep breast tissueCannot view the axillary lymph nodesTypically used for diagnosing abnormalities found during screening
Does not use radiation
Can help distinguish between solid masses and cysts
Better at spotting abnormalities in people with dense breast tissue
Much less effective at finding calcifications
Cannot view the entire breast
Cannot view deep breast tissue
Cannot view the axillary lymph nodes
Typically used for diagnosing abnormalities found during screening
Risk Factors
Having afamily history of breast canceror inherited genetic mutations like breast cancer gene 1 and breast cancer gene 2 (BRCA 1 and BRCA 2, respectively) put you at higher risk for developing breast cancer.
You will likely needyearly mammogramsbefore the age of 40. Ultrasound may also be recommended, depending on the density of your breast tissue.
Breast Density
Having dense breasts makes finding breast cancer more difficult and increases the risk of developing breast cancer.
Having a mammogram, ultrasound, and possibly an MRI can improve the accuracy of breast cancer screening for people with dense breasts.
Palpable Lump
Insurance
Your insurance will usually cover breast ultrasound if your healthcare provider orders it to help diagnose a lump or a suspicious area seen on a mammogram. Most insurance companies won’t cover breast ultrasound as part of routine cancer screening.
Other Breast Cancer Imaging Options
Neither mammograms nor breast ultrasounds will find all breast cancers. There are options for people who are at a high risk for breast cancer.
Other tests may be used as investigational approaches to breast cancer screening, however, these are not standard recommended tests:
These techniques continue to evolve as researchers look for better ways to find breast cancer in the earliest stages of the disease.
What Are My Options for Breast Cancer Screening?
Summary
There are some key differences between breast ultrasounds and mammograms that you should think about when you’re trying to decide which option is best for you.
Mammograms remain the gold standard for screening, diagnosing, and following up after breast cancer. However, breast ultrasounds play an essential role in identifying breast cancer as well.
If a suspicious mass is discovered on a mammogram, a breast ultrasound can help further evaluate that area. People with dense breasts may need both mammograms and ultrasounds.
Unfortunately, neither mammograms nor ultrasounds are 100% accurate. Knowing how your breasts normally look and feel and reporting any changes to your provider is the first—and most important—step in early detection.
Will Medicare Pay for a Breast Ultrasound?
Frequently Asked QuestionsA breast ultrasound can detect masses that look like they may be cancerous, but imaging is not enough to diagnose the disease. A biopsy, removal of a sample of tissue that is then examined in a lab, is required.A breast ultrasound can pick up fluid-filled masses, which are not likely to be cancerous. However, just as with solid lumps found on an ultrasound, a biopsy is needed to confirm the lump’s status.Breast ultrasounds can help identify lumps that can be felt but don’t show up on a mammogram. Ultrasounds can also identify suspicious activity in dense breast tissue better than mammograms.Learn MoreBenign Breast Problems That Mimic CancerAvoid putting products like sunscreen, lotion, or powder on your chest the day of your ultrasound. Wear a two-piece outfit with a top that you can easily raise up or remove in case you’re asked to put on a hospital gown.
A breast ultrasound can detect masses that look like they may be cancerous, but imaging is not enough to diagnose the disease. A biopsy, removal of a sample of tissue that is then examined in a lab, is required.
A breast ultrasound can pick up fluid-filled masses, which are not likely to be cancerous. However, just as with solid lumps found on an ultrasound, a biopsy is needed to confirm the lump’s status.
Breast ultrasounds can help identify lumps that can be felt but don’t show up on a mammogram. Ultrasounds can also identify suspicious activity in dense breast tissue better than mammograms.Learn MoreBenign Breast Problems That Mimic Cancer
Breast ultrasounds can help identify lumps that can be felt but don’t show up on a mammogram. Ultrasounds can also identify suspicious activity in dense breast tissue better than mammograms.
Learn MoreBenign Breast Problems That Mimic Cancer
Avoid putting products like sunscreen, lotion, or powder on your chest the day of your ultrasound. Wear a two-piece outfit with a top that you can easily raise up or remove in case you’re asked to put on a hospital gown.
How Breast Cancer Is Diagnosed
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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American Cancer Society.Finding breast cancer during pregnancy.
Brem, R.; Lenihan, M.; Lieberman, J. et al.Screening breast ultrasound: Past, present, and future.Am J Roentgenol.2015;204:234-40. doi:10.2214/AJR.13.12072
Kolb, T.; Lichy, J.; Newhouse, J.Comparison of the performance of screening mammography, physical examination, and breast US and evaluation of factors that influence them: An analysis of 27,825 patient evaluations.Radiology.2002;225(1):165-75
Macklin, S.; Gass, J.; Mitri, G. et al.The role of screening MRI in the era of next generation sequencing and moderate-risk genetic mutations.Fam Cancer. 2017;17(1):167-73. doi:10.1007/s10689-017-0007-9
Miglioretti, D., Lange, J., van den Broek, J. et al.Radiation-induced breast cancer incidence and mortality from digital mammography screening.Ann Int Med. 2016;164(4):205-14. doi:10.7326/m15-1241
National Cancer Institute.Breast cancer screening (PDQ) – Health professional version.
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