Breast Cancer Screening Basics

When people think of breast cancer screening, the mammogram is usually the first diagnostic screening method that comes to mind. While mammography is definitely the most common and most accessible tool for breast cancer screenings, it’s not the only tool.

The mammogram works for most, but it does have its limitations. For one thing, women with fibrous breasts often have difficulty getting a clear reading with mammography, and the procedure can also be incredibly uncomfortable for women who have smaller breasts. Additionally, the mammogram will only detect existing tumors, while other methods may help determine how likely you are to develop tumors or certain types of breast cancer.

Tumor Screening Methods

These methods detect tumors and other abnormal growths, but they cannot detect your potential to develop cancer if no tumors are present.


The ultrasound uses high-frequency sound waves to take images of your breasts. Like the mammogram, it detects masses and other abnormalities in the breast, which could indicate cancer. Unlike the mammogram, the ultrasound does not use radiation, and it does not require the technician to flatten the breasts between two plates. Instead, the technician applies a conductive gel to the breasts and gently presses the ultrasound wand against the breasts to get an image of the breast tissue.

Because ultrasound uses no radioactivity, it is an ideal medical imaging method for pregnant women. Ultrasounds are also good for women with dense and fibrous breasts who might get an inconclusive reading from a mammogram.

Magnetic Resonance Imaging (MRI)

The MRI uses high-powered magnets to take images of your breasts. Like the ultrasound and the mammogram, it can detect masses and other abnormalities in the breasts. The MRI can also show the extent of the tumor growth, which is something a mammogram cannot do.

The MRI is good for women with dense and fibrous breasts who might not get a clear reading from a mammogram, and for women who are at high risk for developing breast cancer. MRI is also a good secondary screening for women who received a positive result from their mammogram or ultrasound, as it provides more information on the nature of the tumor.

Genetic Screening Tests for Breast Cancer

Genetic screening tests do not detect tumors; rather they detect your potential to develop breast cancer.

Currently the BRCA1 and BRCA2, or the BRACAnalysis, test is the only genetic test that is commercially available. BRCA stands for BReast CAncer, and the test detects the presence of the 1 and 2 versions of the gene. Women with those genes have a higher risk of developing breast and ovarian cancer. The test made the news in late 2013 when actress Angelina Jolie underwent a preventative double mastectomy based on her results from the BRCA test.

Although the test is available to everyone, it is also very expensive and may not be covered by insurance. Currently it is only recommended that women with the following risk factors undergo the BRCA test:

  • Close family members with a history of breast or ovarian cancer

  • A family history of breast cancer before age 50

  • A family history of multiple breast cancers in one patient

  • A family history of male breast cancer

  • Ashkenazi Jewish ethnicity

Women who receive positive results with the BRCA test can take risk-lowering drugs, like tamoxifen and raloxifene. They can also opt for a more extreme approach, such as preventative mastectomy or ovary removal.

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