When determining if you should have a screening ultrasound exam, your doctor will need to know your breast density (from your mammogram) and your breast cancer risk (from the cancer risk assessment).
If you have been told that you are at high-risk for breast cancer (regardless of your breast density):
- You should begin annual screening with Breast MRI beginning at age 25-30
- You should include annual screening with mammography also beginning at least by age 30
If you are a high-risk patient and are unable to have an MRI, then screening ultrasound should be considered (these reasons might include pacemaker, non-MRI compatible implants such as aneurysm clip, pregnancy, history of allergic reaction to gadolinium, severe claustrophobia, severe obesity or poor kidney function).
If you are at average risk for breast cancer, you should know your breast density (from your mammogram) to determine if screening ultrasound is indicated:
- If you DO NOT have dense breast tissue, routine annual mammography is recommended and this would be performed as a 3D/tomosynthesis exam in our practice. 3D mammography is able to detect 1-2 additional cancers per 1,000 women screened. Screening breast ultrasound is not indicated.
- If you DO have dense breast tissue, annual mammography is recommended and this would be performed in our practice as a 3D/tomosynthesis exam. Screening breast ultrasound could be considered as a supplemental screening test in combination with mammography. The addition of ultrasound has been shown to detect 2 to 4 additional invasive cancers per 1,000 women screened.
Screening ultrasound requires a physician referral which allows you to discuss the pros/cons of additional imaging with your provider. Insurance coverage may vary.
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