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Breast cancer screening tests: Mammograms, ultrasounds and MRIs

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Early diagnosis can lead to successful treatment. Learn how to stay on top of your breast health at home and at the doctor’s office.

One in 8 women will have breast cancer in their lifetime.1 And 1 in 833 men will have it, too.11 Staying on top of breast screening is one of the best ways to find breast cancer at its earliest, most treatable stage. And today, the technology is advanced.

“Screening is our best weapon in the fight against breast cancer,” says Joseph Abrams, MD. He’s the chief of breast imaging at ProHEALTH, part of Optum, in Brooklyn and Long Island, New York. “Too many people wait until they feel symptoms.” And this may make cancer more difficult to care for.

Annual screenings can help doctors find breast cancer before there are symptoms. And that helps raise the chance of curing the disease. (Learn more about how to prevent cancer.)

The first step is simply to know your own breasts. Doing regular self-exams can make it easier for you notice a change.

Next, talk to your doctor about the right time to schedule your screenings. Mammograms, ultrasounds and MRIs are the main types of breast cancer screening done by medical professionals. The differences between them can be confusing. We're breaking down the basics of all three tests, including how each is performed and which might be best for you. 

How to stay on top of your breast health at home

No two breasts are alike. Not even your left and right breasts are exactly the same. This is why it’s important to learn what’s normal for your body. You can do this through self-breast exams.

Here’s what you’ll want to look for:3

  • A new lump in the breast or armpit
  • Breast swelling
  • Dimpling of breast skin
  • Flaky skin around the nipple area
  • Nipple discharge (fluid that seeps out of the nipple)
  • Change in size or shape of the breast

Regular self-exams are great for learning about your body. This is especially true if you’re not old enough to start routine mammograms. And once you do, keep up with self-checks. This will help you can spot any potential changes as soon as possible. Here's how to do one.

What’s a mammogram?

A mammogram is the most common type of breast cancer screening.4,5 It’s an X-ray that takes photos of breast tissue. Photos can help your doctor spot anything unusual such as:

  • Tumors
  • Calcifications (calcium in the breast)
  • Asymmetry
  • Deformed tissue

There are two types of mammograms: screening and diagnostic.

  • Screening. An X-ray takes pictures of each breast from two angles. Women with no risk factors or current symptoms usually have this type.4,5
     
  • Diagnostic. An X-ray takes photos of each breast from many angles. It’s mostly used when there’s a lump in the breast or you have another symptom. This test can also be used if the screening mammogram shows any problems. Or it might be done if the person has had breast cancer.4,5

A mammogram machine has two plates that press against the top and bottom of your breast. When the breast is flattened, the doctor can get a better view of the tissue.4

Women ages 40 to 44 with an average risk of breast cancer can choose to get a yearly mammogram. But if you wait, annual screening should start at age 45.6 If you’re at high risk for breast cancer or have certain breast tissue, your doctor may suggest a second type of screening. Or they may suggest starting earlier. Wondering if you’re at high risk? Learn more about genes and breast cancer. 

Join the WISDOM study. This groundbreaking study is testing a personalized approach to breast cancer screening versus annual mammograms. It's easy to join and you complete most of it online. Learn more.

What’s an ultrasound screening?

Ultrasound machines listen instead of look.7 They use sound waves and echoes inside the breast to create computer images. This screening is usually done after a mammogram.

Your doctor will put gel on your breast and then use a wand-shaped device to rub across your skin. Feel a little pressure? This is normal during an ultrasound.7

 Breasts are made up of three types of tissues:8

  • Glandular. This is made up of lobules (small glands that make milk) and ducts (tubes that bring milk from the lobules to the nipples).
  • Fat. This keeps other parts of the breast in place.
  • Fibrous. This gives breasts their size and shape.

“Ultrasounds in addition to mammography are recommended for women with dense breasts,” says Dr. Abrams. Having dense breasts means you have more glandular and fibrous tissue than fat. Glandular and fibrous tissues are harder to see through on a mammogram. They can easily block masses.8

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What’s a breast MRI?

MRI stands for magnetic resonance imaging. It’s used for women who have a higher risk of breast cancer. Your doctor can figure out your chance of getting breast cancer based on many factors. These include:

  • Personal history with breast or ovarian cancer
  • Family history of breast or ovarian cancer
  • Personal history of other high-risk breast abnormalities
  • Genes 
  • Age

MRIs use magnets and radio waves to take photos of deep breast tissue.9 The pictures show more details than mammograms. And this helps the doctor look closely for anything unusual. Before the MRI, your doctor will inject blue dye into a vein.9 This dye gets into your tissues and blood vessels and makes them easier to see in pictures.

Women with a high risk for breast cancer should get an MRI every year. This screening may be done with a mammogram starting as early as age 30.6 You’re at high risk for breast cancer if:

  • You or a family member has had breast or ovarian cancer
  • You have genes that lead to the illness

MRIs, mammograms and breast ultrasounds show unusual changes in breast tissue. If your doctor finds something out of the ordinary, they may order a biopsy. A biopsy involves taking a sample of tissue from the body. The doctor will then test the tissue to see whether it’s cancerous. The hopeful news? Women with early-stage breast cancer have a 90% five-year survival rate.10

The bottom line? No one knows your breasts better than you. Keep up with self-exams and talk to your doctor about which screening is best for you. If you have insurance, routine mammograms must be covered. If you don’t have a health plan, here’s how to find affordable screening near you.

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Sources

  1. American Cancer Society. Key statistics for breast cancer. Last revised January 12, 2022. Accessed August 16, 2022.
  2. Breastcancer.org. Starting breast cancer screening at age 40 instead of 50 saves lives. Last updated July 31, 2022. Accessed August 16, 2022.
  3. Centers for Disease Control and Prevention. What are the symptoms of breast cancer? Last reviewed September 20, 2021. Accessed August 16, 2022.
  4. American Cancer Society. Mammogram basics. Last revised January 14, 2022. Accessed August 15, 2022.
  5. National Cancer Institute. Mammograms. Updated September 30, 2021. Accessed August 15, 2022.
  6. American Cancer Society. American Cancer Society recommendations for the early detection of breast cancer. Last revised January 14, 2022. Accessed August 30, 2022.
  7. American Cancer Society. Breast ultrasound. Last revised January 14, 2022. Accessed August 15, 2022.
  8. American Cancer Society. Breast density and your mammogram report. Last revised March 10, 2022. Accessed August 17, 2022.
  9. American Cancer Society. Breast MRI. Last revised January 14, 2022. Accessed August 15, 2022.
  10. American Cancer Society. Survival rates for breast cancer. Last revised March 1, 2022. Accessed August 30, 2022. 
  11. Breast Cancer Research Foundation. What to know about male breast cancer. Published February 11, 2022. Accessed September 22, 2022.

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