Other breast cancer screening tests

Mammography is the current standard test for breast cancer screening. MRI is also recommended along with mammograms for some women at high risk for breast cancer. Ultrasound and other tests may also be helpful for some women.

Breast ultrasound

Ultrasound, also known as sonography, is an imaging method using sound waves to look inside a part of the body. For this test, a small, microphone-like instrument called a transducer is placed on the skin (which is often first lubricated with ultrasound gel). It emits sound waves and picks up the echoes as they bounce off body tissues. The echoes are converted by a computer into a black and white image on a computer screen. This test is painless and does not expose you to radiation.

Breast ultrasound is sometimes used to evaluate breast problems that are found during a screening or diagnostic mammogram or on physical exam. Breast ultrasound is not routinely used for screening. Some studies have suggested that ultrasound may be a helpful addition to mammography when screening women with dense breast tissue (which is hard to evaluate with a mammogram), but the use of ultrasound instead of mammograms for breast cancer screening is not recommended.

Ultrasound is useful for evaluating some breast masses and is the only way to tell if a suspicious area is a cyst (fluid-filled sac) without placing a needle into it to aspirate (pull out) fluid. Cysts cannot be accurately diagnosed by physical exam alone. Breast ultrasound may also be used to help doctors guide a biopsy needle into some breast lesions.

Ultrasound has become a valuable tool to use along with mammograms because it is widely available, non-invasive, and less expensive than other options. However, the effectiveness of an ultrasound test depends on the operator's level of skill and experience. Although ultrasound is less sensitive than MRI (that is, it detects fewer tumors), it has the advantage of being more available and less expensive.

Tomosynthesis (3D mammography)

This technology is basically an extension of a digital mammogram. For this test, the breast is compressed once and a machine takes many low-dose x-rays as it moves over the breast. The images taken can be combined into a 3-dimensional picture. Although this uses more radiation than most standard 2 view mammograms, it may allow doctors to see problem areas more clearly, lowering the chance that the patient will need to be called back for more imaging tests. A breast tomosynthesis machine was approved by the Food and Drug Administration (FDA) in 2011 for use in the US, but the role of this technology in screening and diagnosis is still not clear.

Other tests

Other tests may be useful for some women, but they are not used often and have not yet been found to be helpful in diagnosing breast cancer in most women. These include scintimammography, thermography, ductogram, nipple discharge exam, nipple aspiration, and ductal lavage. These tests are discussed in more detail in our documents, Breast Cancer and Mammograms and Other Breast Imaging Procedures.

Talk to your doctor

If you think you are at higher risk for developing breast cancer, talk to your doctor about what is known about these tests and their potential benefits, limitations, and harms. Then decide together what is best for you.

For more information on imaging tests for early detection and diagnosis of breast diseases, refer to the separate American Cancer Society document, Mammograms and Other Breast Imaging Procedures.