Mammogram vs Ultrasound – Which is Right For You?

October is Breast Cancer Awareness Month, and if you’re at risk of this deadly disease, it’s important to get screened on schedule. Mammograms are generally the go-to for screening, but ultrasounds have sometimes been requested for individuals. What’s the difference between the two? Which is right for you? I’ll answer these two questions and more in this article.

Breast Cancer – The Basics

After skin cancer, breast cancer is the most common cancer women suffer from in the United States.

The different types of breast cancer include

• Angiosarcoma
• Recurrent breast cancer
• Inflammatory breast cancer
• Invasive lobular carcinoma
• Male breast cancer
• Ductal carcinoma in situ (DCIS)
• Lobular carcinoma in situ (LCIS)
• Paget’s disease of the breast

The symptoms and signs can vary depending on the type of cancer, but if you notice any of the below, you should schedule an appointment with a doctor immediately:

• Sudden inverted nipple
• Changes in skin including peeling, scaling, pitting, redness, flaking, dimpling, or crusting
• Breast lumps
• Thickening
• Discharge that is not milk
• Changes in the appearance of the breast, which can include skin changes as well as
shape and sizes of the breast

Mammogram vs Ultrasound

Screening is essential to finding breast cancer as early as possible, but what IS a mammogram? And how does it differ from an ultrasound?

What is a Mammogram?

A mammogram is an x-ray image of your breasts. The images will be in 2-D and 3-D, and allow the radiologist, gynecologist, and oncologist a view of them from all angles. Mammograms can be for screening as well as diagnostic.

What is an Ultrasound?

Ultrasounds are often used to uncover various health problems, but also for pregnancies. A breast ultrasound scan works the same way – a transducer, a wand-like device, moves over your breasts and uses high-frequency sound waves to get images.

Mammogram vs Ultrasound – Which is Right for You?

Understanding the differences between the two will help you determine which is the right breast cancer screening process for you. Use this table to answer some of the most commonly asked questions:

Which is Right for…
Mammogram or ultrasound?
Detecting small calcium deposits, also known as microcalcifactions?
Mammogram
Ultrasounds cannot detect these.
Those over the age of 60?
Mammogram
Those under the age of 45?
Ultrasound, in some cases
Dense breasts?
Ultrasound
A mammogram does not always work well with dense breasts.
Large breasts?
Mammogram
An ultrasound may not be able to get accurate images.
Those who are overweight?
Mammogram
Individuals with risk factors?
Mammogram

Both mammograms and ultrasounds can help, too, after breast cancer has already been detected and can assist with biopsies.

However, you should always talk to your doctor about the pros and cons of each test. They will be able to guide you in the best direction for your health and also be able to detail why one diagnostic test is better than the other for your situation. In some cases, the doctor may recommend you get both.

When Should You Be Screened for Breast Cancer?

Recommendations for screening can vary a bit from organization to organization. However, general guidelines for women tend to be:

• Under the age of 40
◦ Medical screening for breast cancer is generally not recommended for those
under the age of 40, unless you have certain risk factors, including a family history
or history of breast cancer.
◦ If you’re of average risk, you should be seeing your gynecologist each year for a
clinical breast exam and performing self-exams on yourself each month.
• 40 to 49 years old with average risk
◦ Should think about breast cancer screening and talk to their doctor about their
risk.
• 50 to 74 with average risk
◦ Should be screened every 1-2 years

It’s important to note that your risk for breast cancer may also play a role in how often you are screened or whether or not your doctor recommends a mammogram or ultrasound. Various risk factors include:

• Age
◦ Those over the age of 50 are much more likely to get cancers, including breast
cancer.
◦ Your age when you experience puberty and menopause can also impact your
chances. Those who had their first period after the age of 12 and/or had their
menopause start after the age at 55 are at higher risk.
◦ In addition, being over the age of 30 at first pregnancy or never having been
pregnant can also increase your chances.
• Genetics and family history
◦ If you have a family history of breast cancer, you are more likely to be diagnosed
with it yourself. For DNA testing, BRCA1 and BRCA2 means you’re at higher risk
of both breast cancer and ovarian cancer.
• Certain breast types
◦ Those with denser breasts have been found to have higher risk.
• Exposure to certain drugs and therapies
◦ Individuals who have undergone radiation therapy, taken some types of birth
controls, or were given diethylstilbestrol (DES) between 1940 and 1971 are more
at risk.
• Lifestyle
◦ Lifestyle choices, including little to no exercise, too much alcohol, and
overweight, can all increase your chances of getting breast cancer.
• History of breast cancer or conditions
◦ If you previously had breast cancer or other breast conditions, you’re at higher
risk of being diagnosed a second time.

Understanding your risk and getting screened on time is essential to catching breast cancer early. The earlier it’s spotted, the higher the survival rate. If you’re not sure when you should be tested, your risk, or whether or not you should be getting an ultrasound or mammogram, make sure to talk to your doctor at your next appointment!

Are you concerned about your risk? Or suspect something may be wrong? It’s easy to book an appointment with me – simply call 626-360-3258.

Sources:

Breast Cancer Screening Guidelines for Women – Centers for Disease … https://www.cdc.gov/cancer/breast/pdf/breast-cancer-screening-guidelines-508.pdf.
“Breast Cancer.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 27 Apr. 2022, https://www.mayoclinic.org/diseases-conditions/breast-cancer/symptoms-causes/syc-20352470.
“What Are the Risk Factors for Breast Cancer?” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 26 Sept. 2022, https://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm.