You may need to add a breast ultrasound to your list of annual checkups
Have you ever gotten an ultrasound to check for breast cancer? If so, chances are you probably had a mammogram to go with it.
"In addition to mammograms and MRIs, breast ultrasounds can be a helpful diagnostic and screening tool for breast cancer," Dr. Thaïs Aliabadi, OB-GYN at Cedars-Sinai Medical Center, tells us. "Many times mammograms will require the help of an ultrasound to confirm certain abnormal findings."
Mammograms vs. ultrasounds
It is important to understand that ultrasounds are not (and should not be) used in place of mammograms. Aliabadi explains, "Mammograms can detect abnormalities that breast ultrasounds cannot and are still the gold standard for breast cancer screening. [Ultrasounds] are only used as an additional tool to screen and to evaluate any abnormal findings."
Mammograms and ultrasounds work in completely different ways, which is why they can discover different things. Mammography uses low-dose X-rays to create an internal image of your breast. Ultrasounds, on the other hand, "are completely safe. They use sound waves and do not produce any radiation. They are also generally quick and painless," Aliabadi explains.
Yet she adds, "In regards to breast cancer screening, ultrasounds alone are not effective in detecting microcalcifications and other abnormal findings relating to breast cancer. This is why they do not replace mammograms in breast cancer detection."
When to use ultrasounds
As mentioned earlier, mammograms are "still the gold standard" in the medical field. If you are over 40, you should continue to schedule your annual mammogram to stay on top of your breast health and possibly detect any stages of cancer. And in most cases your doctor may not even prescribe an ultrasound to supplement the mammogram results.
Now... with that said, mammograms have been getting a bad rap, with claims of them, well, not working so great. This is where ultrasounds should come into play: "Oftentimes ultrasounds can be prescribed when patients have a personal history of breast cancer, a strong family history of breast cancer and/or if patients have dense breasts," Aliabadi explains. "The age of the patient plays a role in when ultrasounds and other breast diagnostic methods are recommended. Ultrasounds can also be used to follow up on benign breast disorders such as fibroadenomas and breast cysts."
Density and accuracy
In particular, women with dense breasts have it more difficult. Dense breasts are made up of fewer fat cells and more glandular and connective material than "typical" breasts. Therefore, detecting cancer with mammograms can be a bit more challenging, as connective material can show up similarly to cancer in images. Dr. Carolyn Runowicz, an obstetrics and gynecology professor at Florida International University in Miami, explains it this way to The New York Times: "It’s like looking through a window with snow on it, searching for a drop of milk."
In these cases, doctors may prescribe additional testing, like ultrasounds or MRIs. This can sometimes give doctors a different pair of glasses, so to speak, in which to see what's really going on beneath the surface. The downside, however, is that sometimes, with additional screenings, there may be a higher chance of false positives (detecting a "cancerous" mass that turns out to be benign), the result in additional testing or biopsies, as Susan G. Komen Foundation explains.
Keep a level head
In detecting breast cancer, it may seem that for every up there is a down. But whatever the case may be, it is important to remain calm about all this. The truth of the matter is that we do not have a single, 100 percent effective means of detecting breast cancer, although technology continues to advance every day. Keep these things in mind:
- Mammograms detect cancer every day. And they detect cancer in women with dense breasts every day.
- Mammograms are still effective tools in many cases, and given the choice, digital mammograms are better than film, yet 3-D mammograms (aka tomosynthesis) are the best.
- False positives may not be ideal, but they are much better than false negatives.
- Find a doctor you have confidence in and trust... and then trust their expertise. But when in doubt, you can always get a second opinion.
- But also, be open. "It is important to discuss your complete personal and family history with your physician so he or she can evaluate your risk and make the best recommendation," Aliabadi explains.