A study published this week in the Journal of the American Medical Association has received extensive media attention because it found that ultrasound was able to find some cancers that mammography missed. 

But, as always, there were caveats.

One: ultrasound found a lot of things that were not breast cancer, leading to many unnecessary tests. The study found that by adding screening ultrasound (using ultrasound to look at the whole breast) to mammography, 55% more cancers were found in high risk women. That sounds like a lot. But in fact there were only 12 more cancers in the whole study that were detected only by ultrasound.  But of  the additional 233 women who needed biopsies because their additional ultrasound “saw something” only 20 had cancer. 

Two: As I point out in Deborah Kotz’s blog On Women on the U.S News & World Report website, there is no evidence that adding ultrasound to mammography will actually reduce your risk of dying of breast cancer.

We’ve long assumed that finding a cancer early will reduce your chance of dying. However, recent data suggests that not all cancers are the same. Some are more aggressive than others and just finding them early may not be enough.  Likewise, some cancers are so slow growing that finding them early isn’t as important in terms of survival. The researchers haven’t followed these women long enough–and it would take years–to know if adding ultrasound really did save lives.

Three: Breast ultrasound is expensive, takes a lot of time to do, and is not available at all medical centers.

Four: MRI is better than ultrasound. In March 2007 the American Cancer Society released new breast cancer screening guidelines which recommend that high-risk women receive an MRI and a mammogram. 

Bottom-line: Mammography, which is far from perfect, remains the best test for women at average risk of getting breast cancer. For those who are high-risk, adding MRI to mammography is a good choice, but MRI cannot be used instead of mammography.

Share →

11 Responses to Ultrasound & Mammography: New Research, No Answers

  1. ninicholson says:

    I have breast cancer and I never had a bad mammogram. I found the lump myself. Even when we knew the lump was there they couldn’t get it to show up on a mammogram. It showed up clearly on the ultrasound. Our local newspaper did an article recently saying that women should have an ultrasound very other year. It said mammograms only catch 50% of cancers, especially women with dense breast. They quoted the price of an ultrasound at $87. I thought that was very reasonable. I will follow up on that article to see if that price is realistic.

  2. ajbrosh says:

    I was diagnosed with breast cancer at in March (age 42) and had been having annual mammograms for 5 years because my mother had breast cancer. I found the lump myself and it did not show up on the mammograms or on an MRI. It showed up just enough on the ultrasound to warrant a biopsy which led to the diagnosis. It seems faulty to rely on any one particular kind of screening device and doctors should use everything in their power to make sure they are not missing anything. At the end of the day self exams are essential for every women!

  3. MIMS SHEPAS says:

    IN MAY IT WAS TIME FOR MY MAMOGRAM, HAD HAD A LUMPECTOMY 7 YEARS AGO, AND NEVER HAD A ULTRA SOUND SINCE THEN , ASKED THE ONCOLOGISTS PA FOR ONE AND SHE SAID “WHY” SAID ITS BEEN 7 YEARS, WELL OK, SHE SAID,
    SO HAD ULTRA SOUND AND DIGITAL MAMO ON THE SAME DAY. THE NEXT DAY SHE CALLED TO TELL ME GUESS WHAT?? YOU HAVE CALCLIFICATIONS THAT SHOWED ON THE MAMO AND A MASS THAT SHOWED ON THE ULTRA SOUND, SO THIS WAS FOLLOWED BY BIOPOSYS OF BOTH AND TURNED OUT TO BE INVASIVE CANCER ..BOTH NEW CANCERS AND NOTHING TO DO WITH THE CANCER OF 7 YEARS AGO. .
    I WAS THEN TOLD I NEEDED TO HAVE A MASTCETOMY, ASAP, THEY SEND ME TO A SURGEON, WANTED TO SEE A BREAST SURGEON BUT THEY SAID NO TIME, SAW A PLASTIC SURGEON, HE COULD NOT BE THERE FOR THREE WEEKS TO WORK WITH THE SURGEON FOR A RECONSTRUCTION , SO WENT AHEAD WITH JUST THE MASTCETTOMY….

    AFTER LEAVING THE HOSPITAL I FELT AWFUL, LIKE BEING AMPUTATED, AND MUTALATED, AND I WAS FULL OF FLUID, THE SURGEON TOOK OUT THE DRAINS TO SOON, AND I HAVE CONTINUED FOR THE LAST 6 WEEKS GOING IN TO BE NEEDLE ASPERATED. FINALLY HE SAID ALL DONE, I STILL THINK ONE SIDE HAS A LOT OF FLUID…

    ANYWAY NEXT WEEK OR BY AUGUST 1ST WILL HAVE TO START CHEMO. NOT LOOKING FORWARD TO IT, 3 HOUR TREATMENTS, AND WILL LOOSE HAIR AFTER ONE WEEK. BEEN THERE DONE THAT ALSO 7 YEARS AGO AND RADIATION.

    HATE THE WAY MY CHEST LOOKS, LOOKS LIKE TWO DIFFERENT SURGERYS …WANT TO HAVE RECONSTRUCTION, WITH A DIFFERENT PS THAN I SAW BEFORE, ACTUALLY WANT TWO COUNSULTS, AND WILL FIGHT FOR THAT, WITH MY PRIMARY AND MY INS IF NEEDED.
    PRETTY MUCH THAT IS MY STORY THUS FAR. I KNOW I’M NEGATIVE, SEEING THE GLASS AS HALF EMPTY INSTEAD OF HALF FULL. BUT I WILL TRY TO GET HAPPY AT SOME POINT.
    WELL I DON’T EVEN KNOW HOW THEY WILL CHECK ON ME FROM NOW ON. ULTRA SOUND OR MRI???NOT SURE.

    MIMS SHEPAS

  4. michelecantwell says:

    I had a negative mammogram and ultrasound. But I had noticed changes, so my doctor suggested an MRI (it was a question whether the insurance would pay for it)…. and it (the cancer) showed up on MRI.
    I’m glad my doctor listened to me and took that extra step.

  5. Deborah says:

    I have had mammograms since I was 35. This year at 52, I found a lump in my right breast. A follow up mammogram said that there was nothing there. It turns out that it was 10 centimeters (4 inches) and six lymph nodes were involved.

    Women need to understand that mammograms cannot find lobular carcinoma. Most women have no idea that there are different types of breast cancer. An MRI said that the tumor was 2.7 centimeters. It also said that the other breast was clear. I decided to have a bilateral on 9/29/08 and there was 1.1 millimeter of cancer in the other breast. Lobular cancer has a very high chance of going to the other breast.

    I have waited for reconstruction and it has made my recovery much easier. With a tumor this size, I didn’t want anything to interfere with my chemo. I am still waiting to start chemo. I expect it to start in November. The whole process has taken much longer than I expected. I found the lump in July. Still haven’t even had a PET scan or a genetic test. I have an aunt with breast cancer, two first cousins (both sides of family), cousin with ovarian cancer and mother died of cancer of the abodomen. If the genetic testing had been given to me, maybe I would have at least had an ultrasound.

    When I was given my old mammograms to bring to the surgeon, found a radiologist’s report from 2004 stating that an ultrasound was recommended. My gyn never had it done! He has never called me since my diagnosis. I have been his patient for 11 years.

  6. click says:

    I must say that I was surprised to find this web page, but – – – Good Job.

  7. Jean Hughes says:

    I have fibroid cysts so feeling lumps in my breasts is nothing new. I went to my gyn on March 20 with many fibroid cysts and he said he might feel something but wouldn’t be surprised if it wasn’t also a fibroid cyst. He said go ahead and have a mammogram and if necessary and ultra sound even though it has only been 5 months since your last mammo. Two weeks later both came back normal. But I went back because I now have some purpling around the nipple. My doctor and I both thought it was bruising from the mammo. But he then sent me to a surgon who performed a bioposy immediatly and called me on May 1 saying it was cancer. The tumor was 7cm by 4cm. Here’s the question: Should I have been having MRIs because of years of documented dense breast tissue and fibroid cysts? Do doctors not reccomend them because insurance doesn’t cover MRIs? I would have paid for it myself if I had only known that mammograms can’t see cancer in women with dense breast tissue. How can we change this? I had been diligent with mammograms as my sister is a breast cancer survivor.

  8. click says:

    This site is truly a great resource thanks for all your hard work

  9. Jane says:

    A request to those who comment: please identify the type of cancer with which you were diagnosed. To say, “They found breast cancer,” is far too vague, given that, at least currently, it could have been ductal carcinoma in situ, or lobular carcinoma in situ, and then all the types of invasive cancers.

  10. It is appropriate time to make some plans for the longer term and it
    is time to be happy. I have read this submit and if I could I
    want to suggest you some fascinating things or tips. Maybe you
    could write subsequent articles regarding this article. I desire to learn even more things about it!

  11. Isidra says:

    It’s a pity you don’t have a donate button! I’d most certainly donate to this superb blog!
    I suppose for now i’ll settle for bookmarking and adding your RSS
    feed to my Google account. I look forward to new updates and
    will talk about this blog with my Facebook group.
    Talk soon!

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>