“I’ll just do an ultrasound instead.”

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I hear this quite a bit and I understand why.  We add supplemental screening by ultrasound for women with dense breasts (Cat D) and we also note that we may miss small masses in heterogenously dense breasts (Cat C) — but, this does not mean you should skip your mammogram nor does it mean that a mammogram in a dense breast is not useful.

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Mammograms and ultrasounds do different jobs.
They are not interchangeable.

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Mammograms:
- The only modality approved for breast cancer screening
- Picks up calcifications (often the earliest sign of breast cancer- Stage 0)

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Ultrasound:
- Helps us to characterize lesions and evaluate lumps
- Useful in dense breast tissue as a supplemental tool not as s replacement

But here’s the part that matters most:

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I have seen cancers that were:
- Clearly visible on mammogram
- Completely invisible on ultrasound

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Let that sink in. This is especially true with DCIS ( Ductal carcinoma in situ)- Stage 0 cancers

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Choosing “ultrasound only” can mean missing something important.

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This isn’t about choosing one.  It’s about using the right tool at the right time.

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Screening saves lives. Early detection changes outcomes.

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Thank you 

Dr. Ify

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