From the Guidelines
Diagnostic mammography and diagnostic ultrasound are medical imaging techniques used to investigate breast abnormalities, with diagnostic mammography providing detailed X-ray images and diagnostic ultrasound using sound waves to create images of breast tissue. These techniques are used to evaluate symptoms like a lump, pain, nipple discharge, or a suspicious finding on a screening mammogram. Diagnostic mammography differs from screening mammography by taking additional views of the breast from different angles and may include magnification views to examine suspicious areas more closely 1. Diagnostic ultrasound, on the other hand, helps distinguish between fluid-filled cysts and solid masses, guides needle biopsies, and is particularly useful for examining dense breast tissue where mammography may be less effective 1. Some key points to consider when using these imaging modalities include:
- The initial evaluation of a palpable mass in women aged 30 years or older begins with a diagnostic mammogram and ultrasound 1.
- For women aged 30 to 39 years, either ultrasound or diagnostic mammography can be used for initial evaluation 1.
- Correlation between imaging and the palpable area of concern is essential 1.
- Any highly suspicious breast mass detected by imaging should be biopsied, irrespective of palpable findings 1. These complementary imaging methods help healthcare providers accurately diagnose breast conditions, determine if a biopsy is needed, and develop appropriate treatment plans for patients with breast concerns. The use of diagnostic mammography and ultrasound is guided by recommendations such as those from the National Comprehensive Cancer Network (NCCN) and the American College of Radiology (ACR), which emphasize the importance of thorough imaging workup and correlation between imaging and clinical findings 1.
From the Research
Diagnostic Mammography and Diagnostic Ultrasound
- Diagnostic mammography is a type of imaging test used to evaluate the breast tissue for any abnormalities or cancer [(2,3)].
- Diagnostic ultrasound, on the other hand, is a non-invasive imaging test that uses high-frequency sound waves to produce images of the breast tissue [(4,5,6)].
Key Differences and Uses
- Diagnostic mammography is commonly used as a screening tool for breast cancer, especially in women with a high risk of developing the disease 2.
- Diagnostic ultrasound is often used as a complementary tool to mammography, particularly in women with dense breast tissue or when a mammogram is inconclusive [(4,6)].
- Ultrasound is also used to guide breast biopsies and as a supplemental screening tool in women with dense breasts and a negative mammogram [(4,5)].
Diagnostic Value
- Studies have shown that the addition of ultrasound to mammography and clinical examination can improve the diagnostic value in the diagnosis of breast cancer 6.
- The diagnostic yield of ultrasound is particularly significant in patients with palpable breast lumps or abnormal screening mammography results 6.