What Mammogram Alternatives Are Available and Do They Work?

- Film and digital mammograms

- 3-D mammogram

- Ultrasound

- MRI

- Molecular imaging

- Choosing a method

- What if I have dense breasts?

- What if I have implants?

- Takeaway

Alternatives to mammograms

Mammography uses radiation to produce detailed images of the breasts. It’s used in routine screening and to aid in the diagnosis of breast cancer.

In the United States, mammograms are a common early detection tool. In 2013, 66.8 percentTrusted Source of women 40 years old and over had had a mammogram within the previous two years.

Mammography is a common way to screen for breast cancer, but it’s not the only screening tool.

Read on to learn more about different types of mammography, as well as the potential benefits and risks of alternative or complementary screening tools.

Film and digital mammography

Film and digital mammograms are both considered to be the “standard” form of mammography. They’re performed in the same way.

You’ll disrobe from the waist up and put on a gown that opens in front. As you stand in front of the machine, a technician will position your arms and place one breast on a flat panel. Another panel from above will compress your breast.

You’ll be asked to hold your breath for a few seconds while the machine takes a picture. This will be repeated several times for each breast.

The images are viewed and stored on sheets of film or as digital files that can be viewed on a computer. In the United States, you’re more likely to have digital mammography.

Digital has a few advantages over film. Digital files can be easily shared among doctors. The images can also be enlarged for better viewing, and suspicious areas can be enhanced.

Mammograms are a good early detection tool. They’ve been shown to reduceTrusted Source deaths from breast cancer in women ages 40 to 74. They can sometimes be uncomfortable, but generally don’t cause severe pain or side effects.

There are some concerns, though. Screening mammograms miss 1 in 5Trusted Source breast cancers. This is called a false negative.

Not all suspicious breast tissue turns out to be cancer. Abnormal mammograms call for additional testing to rule out breast cancer. This is called a false positive.

Having dense breast tissue increasesTrusted Source the chances of a false result. But having previous mammograms for comparison can cut the chances of a false result in halfTrusted Source.

Mammography uses low doses of radiation. The risk of harm from a mammogram is lowTrusted Source, but it does have the potential to cause cancer when repeated over time. Also, radiation should be avoided if you’re pregnant.

Under the Affordable Care Act (ACA), breast cancer mammography screenings are covered for women over 40 every one or two years. It’s usually covered under Medicare as well.

3-D mammography (breast tomosynthesis)

3-D mammography is a newer type of digital mammography, but it’s performed in much the same way as other mammograms.

Images are taken in thin slices and at multiple angles, then combined to make a complete picture. It may be easier for radiologists to see breast tissue more clearly in 3-D.

3-D mammography requires about the same amount of radiation as digital mammography. However, more pictures are needed, which may lengthen the testing time and the amount of radiation exposure.

It’s not yet clearTrusted Source if 3-D is better than standard digital at detecting early breast cancer or lowering the false-positive or false-negative rates.

3-D mammography isn’t always 100 percent covered by health insurance.

Learn more: Tomosynthesis: What to expect »

Ultrasound

Ultrasound uses high-frequency sound waves rather than radiation to produce pictures of the breast.

For the procedure, some gel will be placed on your skin. Then a small transducer will be guided over your breast. The pictures will appear on a screen.

This is a painless procedure that typically doesn’t cause side effects.

Ultrasound of the breast may be used after an abnormal mammogram or in women with dense breast tissue. It’s not usually used in routine breast cancer screening for women at average risk.

A 2015 studyTrusted Source found that ultrasound and mammography detected breast cancer at about the same rate. Breast cancers found by ultrasound were more likely to be of the invasive kind and lymph node-negative.

Ultrasound also resulted in more false positives than mammography.

The study authors wrote that where mammography is available, ultrasound should be considered a supplemental test. In countries where mammography isn’t available, it should be used as an alternative.

Learn more: Breast ultrasound »

MRI

MRI doesn’t rely on radiation. It uses magnets to create cross-sectional images of your breast. It’s painless and normally doesn’t involve side effects.

If you have a breast cancer diagnosis, MRI can help find additional tumors and assess tumor size.

MRI is usually not recommendedTrusted Source as a screening tool for women at average risk of breast cancer. It’s not as effectiveTrusted Source as mammography in finding tumors and is more likelyTrusted Source to produce a false-positive result.

Insurance may not cover MRI as a breast screening tool.

Molecular breast imaging

Molecular breast imaging (MBI) is a newer test and may not be available near you yet.

MBI involves a radioactive tracer and a nuclear medicine scanner. The tracer is injected into a vein in your arm. If you have cancer cells in your breast, the tracer will light up. The scanner is used to detect those areas.

This test is sometimes used in addition to a mammogram to screen women with dense breast tissue. It’s also used to evaluate abnormalities found on a mammogram.

The test does expose you to a low dose of radiation. There’s a rare chance of allergic reaction to the radioactive tracer as well. MBI may produce a false-positive result or miss small cancers or cancer located close to the chest wall.

MBI may not be covered as a routine breast screening test.

How to decide which method is right for you

Although general screening guidelines exist, there are many things that can factor into how you should be screened for breast cancer. This is a discussion you should have with your doctor.

Here are some things to consider when choosing breast cancer screening methods:

- doctor recommendation

- experiences and results of previous tests

- benefits and risks of each type you’re considering

- existing medical conditions, pregnancy, and overall health

- family and personal history of breast cancer

- what tests are covered under your health insurance policy

- what tests are available in your area

- personal preferences

Mammogram alternatives for dense breasts

Women with dense breasts are advised to have annual film or digital mammograms.

It may be harder to detect cancer in dense breast tissue, particularly if there are no earlier mammograms for comparison.

You may not need additional testing, though. Ask your doctor if ultrasound or MRI is a good idea. This may be particularly important if you’re at higher than average risk of developing breast cancer.

Learn more: Does having dense breasts increase your risk for cancer? »

Mammogram alternatives for implants

If you have implants, you still need regular breast cancer screening. Film or digital mammograms are recommended.

Make sure the mammogram technician knows you have implants prior to the procedure. They might need to take extra images because implants can hide some breast tissue.

The radiologist who reads the images will need to know, too.

It’s rare, but a breast implant can rupture during a mammogram. Ask your doctor if ultrasound or MRI are advisable.

The bottom line

There’s no one-size-fits all rule for breast cancer screening. Much depends on your individual risk factors and comfort level with each screening method.

According to current researchTrusted Source, a woman’s risk for developing breast cancer during the next 10 years, starting at age 30, is as follows:

- At age 30, you have a 1 in 227 chance of developing breast cancer.

- At age 40, you have a 1 in 68 chance.

- At age 50, you have a 1 in 42 chance.

- At age 60, you have a 1 in 28 chance.

- At age 70, you have a 1 in 26 chance.

It’s important to note that your risk for breast cancer may be higher or lower depending on your individual risk factors. Your doctor will be your best resource in determining what your personal level of risk is and how to best go about screening.

Keep reading: Dealing with post-mammogram anxiety »

Last medically reviewed on February 22, 2017

How we reviewed this article:

SOURCES

HISTORY

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Aug 20, 2018

Written By

Ann Pietrangelo

Edited By

Jamie Herrmann

Feb 22, 2017

Medically Reviewed By

Christina Chun, MPH

Breast Cancer Screening: Thermogram No Substitute for Mammogram

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A mammogram (left) is an X-ray image of the breast that can identify tissue types with different densities, such as masses within the breast. Thermography (right) produces an infrared image that shows the patterns of heat on or near the surface of the body.

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The U.S. Food and Drug Administration (FDA) is reminding you that mammography (low-dose X-ray imaging of the breast) is still the most effective primary breast cancer screening test. Proper breast cancer screening lets health care providers check for cancer even before there may be signs and symptoms of the disease.

The FDA has received reports from health care providers and patients that some health centers are providing information that can mislead patients into believing thermography, a type of test that shows patterns of heat on or near the surface of the body, is a proven alternative to mammography. But the FDA is not aware of any scientific evidence to support these claims.

Thermography has not been shown to be effective as a standalone test for either breast cancer screening or diagnosis in detecting early stage breast cancer. Mammography is still the most effective primary screening method for detecting breast cancer in its early, most treatable stages.

More About Misleading Thermography Claims and FDA Actions to Protect the Public

The FDA regulates the medical devices used for breast cancer screening.

About 1 in 8 women in the United States will be diagnosed with breast cancer sometime in their lives, reports the National Cancer Institute, which is part of the National Institutes of Health. Men can develop breast cancer, but it happens much less often than in women. Early detection of breast cancer by using mammography reduces the risk of breast cancer death and increases treatment options, according to the American Cancer Society

External Link Disclaimer

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One of the greatest dangers from thermography is that those who opt for this method instead of mammography may miss the chance to detect breast cancer at its earliest stage.

Thermography devices have only been cleared by the FDA as an “adjunctive” tool, referring to use alongside a primary screening test like mammography. Patients who undergo a thermography test alone should not be reassured of the findings because the device was not cleared to be used other than with another testing method like mammography. (You can learn more about mammography, including how it works and how to find a certified facility, on the FDA's website.)

Moreover, some websites claim thermography can find breast cancer years before it would be detected through other methods, and they have unproven claims about improved detection of cancer in dense breasts. The FDA is not aware of any evidence that supports these claims.

The FDA has taken regulatory action (including issuing warning letters) against health care providers and thermography device manufacturers who have tried to mislead patients into believing that thermography can take the place of mammography. To protect the public health, the FDA’s regulatory actions can include scheduling a regulatory meeting, sending a warning letter or other correspondence, conducting an establishment inspection, or other actions as appropriate.

The FDA continues to monitor this situation.

Advice for Patients Getting Breast Cancer Screening

Some women have sought out thermography because it is painless and does not require exposure to radiation.

If you are worried about how a mammogram feels, talk to your health care provider about what you can expect. A mammogram can be uncomfortable for the person being screened because it briefly presses on the breast to spread the breast tissue and increase the clarity of the X-ray image. (You can learn more about what to expect during a mammogram on the FDA's website.)

Also talk to your health care provider if you have specific questions about mammography, including questions about when and how frequently you should be screened. As a rule, you should also call your health care provider if you notice any change in either of your breasts such as a lump, thickening of or leakage from the nipple, or changes in how the nipple looks.