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May 25, 2020 09:17AM
Jons_girl (and others), I know that I've mentioned this to you before, but I will say it again.
Mammos do work, even for those who have dense breasts - but not in every case and not every time.
Ultrasounds do work - but not in every case and not every time.
Neither mammograms nor ultrasound are effective all of the time, and this is why for those of us who have dense breasts, having both a mammogram and an ultrasound is the recommended approach. Each screening modality views the breast differently, and as a result, they "see" different things. So while a mammogram might miss something that an ultrasound picks up, particularly for someone with dense breasts, it is equally true that an ultrasound might miss something that a mammogram picks up, even for someone with dense breasts.
I realize that several of the posters here had their cancer picked up by an ultrasound after it was not seen by a mammogram. My diagnosis of DCIS-Mi was the opposite - despite having extremely dense breasts - my cancer was seen on a mammogram and not seen on an ultrasound.
And here's the thing. The way that someone's cancer presents one time is not necessarily the same way that either a recurrence or a new cancer will present the next time. So the fact that the ultrasound found the cancer last time doesn't mean that a recurrence will present the same way and again be visible on an ultrasound. It could happen that way, or it could happen that next time an ultrasound will miss the cancer whereas a mammogram would find it.
I am by no means suggesting that mammograms are enough for anyone with dense breasts. What I am saying is that ultrasounds too are not enough. The best tool to add to screening for those with dense breasts is an MRI, but those are not readily available to everyone, and annual MRIs might not be advisable given the concerns with gadolinium, so combining a mammogram with an ultrasound is the next best thing. To have an ultrasound only is to do yourself a disservice, and put yourself at risk.
"Mammography is the only screening tool for breast cancer that is known to reduce deaths due to breast cancer through early detection. Even so, mammograms do not detect all breast cancers. Some breast lesions and abnormalities are not visible or are difficult to interpret on mammograms. Breasts that are considered dense have a lot of glandular and connective tissues and not much fatty tissue, and that makes cancer harder to detect....
...Many cancers are not visible on ultrasound. Many calcifications seen on mammography cannot be seen on ultrasound. Some early breast cancers only show up as calcifications on mammography."
. Annual Mammograms vs. Annual Ultrasounds
. Ultrasounds Effective in Detecting Breast Cancer, but You Still Might Want to Have a Mammogram
"Breast ultrasound has its advantages, too. The technician may look for lesions hidden within dense breast tissue (parenchyma), Koehler added. There's no radiation involved.
How effective an ultrasound exam is depends on the skill of the person performing it. Human error can lead to overlooked lesions or misinterpreted results. But unlike mammography, ultrasound can't make out architectural distortions, calcifications, or asymmetries...
..."One is not better than another," she told Healthline. "They are complementary. They should be seen as such and used as such rather than one as a substitute for the other. At least this is the case where both are widely available."
“No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke