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What’s the Difference Between A Breast Mammogram And Ultrasound?


When mammograms show abnormalities, imaging specialists usually recommend breast ultrasound to provide further evaluation and determine the next steps. In specific cases, such as for patients considered high risk for breast cancer, a breast ultrasound recommendation may be part of the initial screening.

As a breast biopsy can be more of an invasive procedure for evaluating breast tissue, the breast imaging specialists here at Little Silver Mammography and HerSpace often recommend patients get a breast ultrasound to make further observations before going through with a biopsy.

Breast Mammogram vs. Breast Ultrasound: What’s the Difference?

A mammogram uses a low dose of radiation to capture detailed images of the breasts. An ultrasound does not use radiation at all and instead captures more detailed images of the breasts using high-frequency sound waves.

As breast ultrasound, unlike CT scans and X-rays, does not use ionizing radiation, it is a safer screening option for younger patients and pregnant women.

What Is A Breast Mammogram?

A mammogram takes an X-ray image of the breast to show abnormal breast tissue and detect early signs of breast cancer. It can detect breast cancer before patients even experience any symptoms, but mammogram findings are rarely cancerous. According to Cleveland Clinic, fewer than 1 in 10 people who require additional screening after a mammogram have breast cancer.

At Little Silver Mammography and HerSpace, we use 3D mammography, or breast tomosynthesis, as it allows radiologists to see the fine details that would otherwise be hidden by surrounding breast tissue using traditional 2D mammograms.

While it creates a much more detailed breast tissue image in a form impossible using 2D mammograms, a 3D mammogram takes a doctor longer to interpret the images. Most imaging centers only recommend 3D mammography to patients with existing abnormalities or risks.

Breast Mammogram: What To Expect

During a 3D breast mammogram, an x-ray arm with low-dose radiation moves over the top and sides of the breasts and gathers images. These thin-section images are then reconstructed into a 3D image so radiologists can evaluate breast tissue layer by layer. 2D mammograms take just two breast images.

Breast mammograms, both 2D and 3D, take about 10-15 minutes.

Is 3D Mammogram Painful?

Some pressure is applied while taking the photos, but it is necessary to get quality enough images to make a diagnosis. While this pressure isn’t harmful, some patients find it uncomfortable. Let the technician know if you are experiencing too much discomfort during your screening.

What Is A Breast Ultrasound?

Breast ultrasound uses sound waves to take images of the inside of the breasts. Breast ultrasound can not only help your doctor find breast abnormalities but also let them see if blood flow to areas in your breasts is moving correctly.

In some cases, ultrasounds are done annually alongside mammograms for high-risk patients, such as women with dense breasts and women with breast implants. Usually, a breast ultrasound is required if:

  • Further evaluation of abnormalities in the breast after noticing changes during a mammogram is needed
  • A non-ionizing radiation screening is needed
  • You are pregnant
  • You are under the age of 25
  • There are no visible symptoms, but you are experiencing some
  • You have found a lump in your breast and need to determine if it is cancerous or benign

Breast Ultrasound: What To Expect

A gel is applied to the breasts before a breast ultrasound and removed once the screening is complete.

During a breast ultrasound, breast imagers move a transducer, a wand-like device, over the breast area. This device produces sound waves that bounce off breast tissue and turn them into images of the inside of the breasts, which are reflected into a computer to create a clear visualization of the areas of concern.

Can You Hear Sound Waves During A Breast Ultrasound?

Breast ultrasound sound waves are high-pitched and not heard by the human ear.

As mentioned above, a breast ultrasound is usually done for further testing after a breast mammogram finds abnormalities or along with a mammogram for the most accurate results possible. However, if you need a non-ionizing radiation screening or, in other specific cases, it may be recommended in place of a routine mammogram. 

If your primary care doctor has not already recommended a breast screening type for you, but you believe it’s time for a screening, schedule an appointment with our NJ breast imagers here at Little Silver Mammography and HerSpace. We will discuss your medical history and concerns and help recommend the best screening plan for your requirements.