Is mammography (mammogram) an X-ray or ultrasound?

Mammography: X-ray Imaging of the Breast

Mammography is an X-ray imaging technique of the breast, not an ultrasound. 1

Definition and Technical Aspects

• Mammography uses low-dose X-ray imaging specifically designed to examine breast tissue 1
• Screening mammography typically consists of 2 standard X-ray images of each breast 1
• Diagnostic mammography includes additional views such as spot compression or magnification views to investigate specific findings 1
• Digital breast tomosynthesis (DBT) is an advanced form of mammographic imaging that creates thin-section reconstructed images to decrease tissue overlap 1

Differences Between Mammography and Ultrasound

• Mammography and ultrasound are complementary imaging modalities, each with distinct roles 1
• Mammography uses X-ray radiation to create images of breast tissue, while ultrasound uses sound waves 1
• Mammography remains the recommended imaging method for breast cancer screening 1
• Ultrasound is often used as a supplemental tool to mammography, especially for:
  • Evaluating palpable masses 1
  • Assessing dense breast tissue 2
  • Distinguishing between solid masses and fluid-filled cysts 3
  • Examining women under 30 years of age (where ultrasound is preferred over mammography) 1

Clinical Applications

• Mammography is primarily used for:

  • Breast cancer screening in asymptomatic women 1
  • Diagnostic evaluation of breast symptoms 1
  • Assessment of abnormalities detected during clinical examination 1

• Ultrasound is typically used for:

  • Evaluating palpable masses, especially in women under 30 1
  • Supplemental screening in women with dense breasts 2
  • Characterizing masses detected on mammography 3
  • Guiding breast biopsies 4

Age-Specific Recommendations

• For women ≥30 years with breast symptoms: Mammography with or without ultrasound is recommended 1
• For women <30 years with breast symptoms: Ultrasound is the preferred initial imaging modality 1
• Under age 35, mammography is rarely justified as the initial imaging test 1

Important Considerations

• Mammography has higher sensitivity for detecting microcalcifications, which ultrasound typically cannot visualize 1
• Ultrasound is better at distinguishing solid masses from cysts 3
• The combination of mammography and ultrasound may increase cancer detection rates, particularly in women with dense breasts, but also increases false positives 2
• Digital breast tomosynthesis (3D mammography) is an advanced form of mammography that can improve detection of breast abnormalities 1, 5

Mammography and ultrasound are distinct imaging technologies that serve complementary roles in breast evaluation, with mammography being an X-ray technique and ultrasound using sound waves to create images of breast tissue.