Mammography is the standard for breast cancer screening, but it’s not the only imaging method that doctors use to get information about breast conditions and possible cancers. In some cases, ultrasound or MRI are chosen to supplement or replace mammography as a breast imaging tool. To help you understand why your doctor may recommend a particular breast imaging procedure, here are some basic reasons that each is often used.
Mammography uses X-rays to image the breasts in order to screen for cancer or investigate an area of concern in the breast. Modern mammography equipment uses digital images (as opposed to film), which allows radiologists to zoom in and get a clearer view of areas of interest for more precise assessment. Breast tomosynthesis, commonly known as 3-D mammography, gives an even more detailed view, as many images are taken in succession to create a three-dimensional picture of the breast that the radiologist can examine a thin layer at a time. This capability makes it easier to identify abnormalities that would otherwise be obscured by surrounding structures. In fact, studies show that the use of 3-D mammography increases cancer detection while reducing the number of false positive results.
Most often, breast ultrasound is used to provide more information about abnormalities found during a physical exam or screening mammogram. Ultrasound can provide valuable information about blood supply to and composition of an area of concern, which can help doctors determine what, if any, further testing should be done.
Ultrasound can be a valuable supplement to mammography because it can allow doctors to detect abnormalities that might not be visible with mammography alone. As a result, doctors may order breast ultrasound to supplement mammography for women who have dense breast tissue or who are at high risk for breast cancer and unable to undergo an MRI. Additionally, ultrasound may be used as a primary breast cancer screening tool for women who are pregnant so they can avoid exposure to the X-rays used in mammography or the contrast solution used in MRI during pregnancy.
Breast cancer screening with MRI is often recommended for women who are at high risk of breast cancer, which is typically determined based on family history. MRI is also considered the best test for assessing whether a breast implant has ruptured.
MRI may be used to evaluate a specific area of the breast following a screening mammogram in the event that mammography and ultrasound alone are not able to adequately image the suspicious area. More commonly, breast MRI is used to determine the extent of newly diagnosed breast cancer, to monitor the effect of neoadjuvant chemotherapy (chemotherapy given prior to surgery), or to monitor lumpectomy sites in the years following breast cancer treatment.
Whichever imaging methods your doctor recommends, the experienced staff at Iowa Radiology provides patient-centered care using state-of-the-art equipment. We are designated as a Breast Imaging Center of Excellence by the American College of Radiology (ACR), meaning that we have attained accreditation in each of the ACR’s voluntary breast imaging programs—including breast ultrasound and ultrasound-guided biopsy, breast MRI, and stereotactic breast biopsy—in addition to the organization’s mandatory mammography accreditation program.
Iowa Radiology is dedicated to providing resources that patients need to make well informed decisions about their health. For more information about mammography, MRI, or mammogram follow up, click the links below to access our free ebooks. For regular updates on a variety of health topics, click here to subscribe to our blog.
 "Benefits of 3-D Mammograms Last Over Time." Breastcancer.org. n.p., 27 Feb 2016. Web. 30 May 2017.
 "Ultrasound - Breast." Radiologyinfo.org. American College of Radiology, 30 Aug 2016. Web. 30 May 2017.
 "Magnetic Resonance Imaging (MRI) - Breast." Radiologyinfo.org. American College of Radiology, 24 May 2016. Web. 30 May 2017.
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