Mammogram or Ultrasound?

Mammography has been the standard imaging method for detecting breast cancer since the late 1960s.

The technology has changed since then, with more advanced machines and much less x-ray exposure. However, current research is now determining the best method for imaging breast tissue, and the contenders are mammography, ultrasound and MRI.

The data has found that ultrasound is more accurate for dense breast tissue, and mammography is better suited for fatty breast tissue.

Data reported in The American Journal of Surgery and the Medical Journal of Malaysi found ultrasound was a more accurate diagnostic method than mammography in the detection of breast cancer in dense breast tissue.

Diagnostic ultrasound was also found to be more accurate than mammography in predicting residual tumor size following chemotherapy.

A study published in the American Journal of Roentgenology found that ultrasound was more accurate than mammography in detecting breast cancer in women 45 years old and younger.

Ultrasound detected 84.9 percent of cancers while mammography detected 71.7 percent of the cancers.

However, mammography was found to be a better tool at detecting breast cancer in fatty breasts and in individuals 50 years and older.

If detection of breast cancer is questionable on both ultrasound and mammography, MRI is suggested for evaluating residual disease and for the subset of tumors not seen on ultrasound and mammography.

Houssami, N., Irwig, L., Simpson, J. M., et al. (2003). Sydney breast imaging accuracy study: Comparative sensitivity and specificity of mammography and sonography in young women with symptoms. American Journal of Roentgenology, 180 (4), 935–40.

Keune, J., Jeffe, D., Schootman, M., et al. (2010). Accuracy of ultrasound and mammography in predicting pathologic response after neoadjuvant chemotherapy for breast cancer. The American Journal of Surgery, 199 (4), 477–84.

Tan, K. P., Azlan, Z. M., Choo, M. Y., et al. (2014). The comparative accuracy of ultrasound and mammography in the detection of breast cancer. Medical Journal of Malaysia, 69 (2), 79–85.