Early detection of breast cancer can save lives. But are all screening methods the same? Bokran Won, M.D., medical director at the Women’s Centers at Riverview Medical Center and Bayshore Medical Center, breaks down the various breast cancer screening technologies and who is best suited for each type.

Traditional Mammography

What is it? Two-dimensional mammography is the most common screening tool and can find tumors that are too small to feel. In a traditional mammogram, the breast is compressed between two rigid plates and X-rays are used to take pictures of the breast tissue.

Does it work? Traditional mammography can show tumors in women with more fatty tissue in their breasts. But it is less likely to find tumors in women with dense breasts since both tumors and dense breast tissue appear white on a mammogram.

Who is it for? Women in the average risk group should receive an annual mammogram starting at the age of 40. Women who are at high risk for breast cancer should receive an annual mammogram earlier than age 40.

3D Mammography

What is it? Three-dimensional mammography uses an electronic detector system to obtain multiple projection images that are synthesized by the computer to show thin slices of the breast. The procedure for a 3D mammogram is the same as a traditional (2D) mammogram—pressing the breast between two rigid plates—but it may take a little longer to acquire images from different angles.

Does it work? 3D digital mammography does find additional cancers not visible on 2D mammography and decreases false positive findings.

Who is it for? Women in the indeterminate risk group (lifetime risk of 12 percent to 20 percent) should get an annual 3D mammogram and should strongly consider supplemental screening tests such as whole breast ultrasound. Women in the average risk group with dense breast tissue (lifetime risk of 12 percent or lower) should get an annual 3D mammogram and may benefit from supplemental screening tests.

Whole Breast Ultrasound

What is it? Whole breast ultrasound is a non-invasive test that uses sound waves to make images of the breast. During an ultrasound, the patient lies on an exam table and the screener places a layer of gel on the breast and presses the ultrasound wand onto and around the entire breast, similarly to how an ultrasound is performed on a pregnant woman’s belly. Whole breast ultrasound does not use ionizing radiation.

Does it work? Breast ultrasound alone is not a good screening method. It’s typically used as a follow-up test after an abnormal finding on a mammogram, breast MRI or clinical breast exam. Whole breast ultrasound can find cancers undetectable on mammograms but also shows more false positive findings. Mammography combined with breast ultrasound may find slightly more breast cancers than mammography alone in women with dense breasts.

Who is it for? Women in the indeterminate risk group (lifetime risk of 12 percent to 20 percent) should get an annual 3D mammogram and strongly consider a supplemental screening test such as whole breast ultrasound. Women in the average risk group with dense breast tissue (lifetime risk of 12 percent or lower) should receive an annual 3D mammogram and may benefit from supplemental screening tests such as whole breast ultrasound.

MRI (Magnetic Resonance Imaging)

What is it? A breast MRI is a diagnostic exam that uses a combination of a large magnet, radio waves and a computer to capture detailed images of the inside of the breast. For the procedure, the woman typically lies face down with her breasts positioned through openings in the table. A breast MRI is performed with contrast injected into a vein in the arm during the procedure to make abnormalities clearer. The procedure does not expose patients to radiation.

Does it work? Breast MRI finds significantly more breast cancers that are undetectable in a mammogram or an ultrasound but also shows more false positive findings.

Who is it for? Some women at high risk may start screening with MRI by age 25 and mammographic screening by age 30. Women in the high-risk group (lifetime risk of 20 percent to 25 percent and greater)—including those with gene mutations such as BRCA1 and BRCA2, a family history of breast cancer, certain genetic syndromes or those who had radiation to the chest between age 10 and 30—should receive an annual mammogram and annual breast MRI with contrast.

Next Steps & Resources:

Meet our clinical contributor: Bokran Won, M.D

To make an appointment with Dr. Won or a doctor near you, call 800-822-8905 or visit our website.

Make an appointment for a breast cancer screening or learn more about the screening technologies offered throughout Hackensack Meridian Health.

Are Mammograms Painful?

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.