MAMMOGRAM VS. ULTRASOUND VS. MRI

Though I’ve never dreaded my yearly mammograms, some of my blog followers have voiced their opposition due to the pain experienced during a mammography. Unfortunately, this has led a few to skip an exam — which is definitely not a good idea.

Medical professionals recommend annual screenings starting at age 40, but I had a friend who died of breast cancer at age 30. Breast cancer is a risk for women of all ages, including those in their 70s, 80s and 90s.

There are alternatives to a mammography. However, from my research (and the opinion of a relative in the medical field), those alternatives, such as ultrasounds and MRIs, are usually conducted in addition to a mammogram if a woman has an abnormal result.

So, let’s review all the options to determine what is right for you:

Screening Mammogram

• This is a low-dose imaging test that detects changes in breast tissue. It is the most effective way to image calcium deposits, which can be the earliest signs of cancer, and identify asymmetries and distortions. Currently, this screening can be done in 2D digital mammography, which captures two X-ray images of the breast, or 3D mammography (digital breast tomosynthesis or DBT), which moves in an arc over the breast and takes multiple X-ray images from many angles. Women should consider 3D screening, especially if they have dense breasts. (I have had this type of mammogram for many years.)

Diagnostic Mammogram

• A radiologist orders specialized 2D and/or 3D mammogram views and evaluates the images in real time. This type of mammogram is ordered if a woman has a palpable mass, pain in the breast, changes in the nipple/skin, or nipple discharge. (I had this this type of mammogram before a breast biopsy.)

Ultrasound

• An ultrasound uses sound waves to image the breast and can be especially helpful for women with dense breasts but should not be used as a substitute for a mammogram. This diagnostic tool is recommended when a mammography detects unusual variations in breast tissue or, as noted above, breast pain, nipple discharge or changes in the skin/nipple.

MRI (Magnetic Resonance Imaging)

• This technology uses the magnetic field and radiofrequency waves to produce images. The patient is given an intravenous contrast solution that enhances the appearance of abnormal tissue. It is used as an additional screening tool to clarify uncertain findings in a mammogram or ultrasound, and is also used for those women who have an increased risk of breast cancer.

If you have concerns about painful mammogram screenings, please discuss with your doctor an alternative — but bear the above information in mind.