Mammogram vs. Breast Ultrasound

These common types of breast imaging can detect breast cancer or other breast conditions. Learn what they can tell you — and when you need one.

When we think breast health, most of us think mammograms. As it turns out, there’s more to breast cancer screening — including a few types of mammograms and another screening method called breast ultrasound. Need any of these tests? Knowing what to expect can make the process a little smoother.

What is a mammogram?

Mammograms are essential tools for detecting breast cancer or changes in breast tissue. During a mammogram, you’ll stand still in front of a specialized X-ray machine. A technologist will position one of your breasts on the plate. Another plate compresses it, making the tissue more uniform.

While your breast is compressed, the technologist will take pictures from different angles. Then they’ll repeat the process on the other breast.

A radiologist reviews the pictures and checks for signs of breast cancer. “If your results are abnormal or can’t be read easily, you may need more testing. This may include diagnostic mammogram and/or a breast ultrasound,” says John Scott Farrell, MD, with Geisinger Diagnostic Radiology.

Types of mammograms

Screening mammogram

Women of average risk for breast cancer should start having screening mammograms at age 40 and then continue screening each year. If a family member had breast cancer, or you have other risk factors, you may need to start screening at a younger age or use more intensive screening. Mammograms are sent to a radiologist who reports the findings, usually after a few days.

Diagnostic mammogram

Diagnostic mammograms are done as a follow-up to a screening mammogram. If you find a lump or have breast pain, you may also need a diagnostic mammogram. The scans are read in real time and you learn the results right away.

3D mammograms

Used for both screening and diagnosis, 3D mammograms offer a 3-dimensional perspective that provides doctors a clearer, more accurate view than a standard mammogram.

“Mammograms usually consist of two X-rays of each breast, top to bottom and side to side,” says Dr. Farrell. “A 3D mammography machine take multiple pictures of each breast from many angles, with the X-ray tube moving in an arc above the breast.”

The breast is positioned and compressed in the same way as a conventional mammogram. Both the time it takes to perform the mammogram and the radiation dose to the patient are not significantly different from a standard mammogram.

3D mammograms are especially helpful for women with dense breast tissue.

What is a breast ultrasound?

A breast ultrasound is a specialized imaging test that allows a technologist to see inside your breasts.

“Unlike a mammogram, which uses X-ray, an ultrasound uses soundwaves to create moving images of breast tissue,” says Dr. Farrell.

During the procedure, an ultrasound technologist applies gel to a wand. Then they’ll move the wand across your breasts, one side at a time, to capture images.

Your provider may suggest a breast ultrasound for a few reasons, like:

Determining if a lump is a cyst or a solid mass
Getting clear images of dense breast tissue
Taking a closer look at a spot that showed as abnormal on a mammogram
Performing a needle biopsy
You’re pregnant or younger than 25

After your ultrasound, the images are sent to a radiologist, who reviews and interprets them.

“If the radiologist finds a suspicious lump or mass, they may recommend a biopsy,” Dr. Farrell says.

What happens if you need more testing?

If your mammogram shows anything abnormal, stay calm. Most of the time, more imaging, like diagnostic mammogram or ultrasound, finds the concerning area is not cancerous. By getting regular breast cancer screenings, you can stay on top of your breast health.

If you have any questions regarding your breast health, contact your healthcare provider.