Harvard Women's Health Watch

Is ultrasound an alternative for breast cancer screening?

Ask the doctor

Q. In your discussions of breast cancer screening, you never mention ultrasound. Is it an alternative to mammography?

A. No. Although the FDA has approved an automated breast ultrasound system to be used in addition to mammography for asymptomatic women with dense breasts, there are not enough published data about its effectiveness in screening to support its use. Moreover, ultrasound alone is not an alternative to mammography for routine breast cancer screening because ultrasound cannot pick up the small deposits of calcium (microcalcifications) that can be a sign of breast cancer.

Preliminary data suggest that whole-breast ultrasound screening, when used in addition to mammograms, detects some additional early-stage breast cancers that are not seen on mammograms in women with dense breast tissue—but at a cost. The addition of ultrasound to mammography screening carries a substantial risk for false-positive results (meaning the test shows a possible problem, yet no breast cancer is present). False-positive results can result in anxiety, breast biopsies with benign results, and a cycle of additional follow-up mammograms and ultrasounds. Moreover, the addition of ultrasound to mammographic screening has not yet been shown to reduce death rates from breast cancer.

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