Regular breast cancer screening is important for all women, but even more so for those at higher risk. If you are at higher risk of breast cancer, you may need to be screened earlier and more often than women at average risk.

A woman is considered at higher risk if she has one factor that greatly increases risk or several factors that together increase risk. Your health care provider may use different tools to assess your risk and help you make a personalized breast cancer screening plan.

What is breast MRI?

Breast magnetic resonance imaging (MRI) uses magnetic fields to create an image of the breast. Breast MRI is more invasive than mammography because a contrast agent is given through an IV before the test.
Breast MRI and breast cancer screening

At this time, breast MRI is mostly used in breast cancer diagnosis and staging, rather than in screening. However, there is growing evidence that breast MRI in combination with mammography is better than mammography alone at finding breast cancer in certain women at higher risk. ACS and NCCN recommend screening with mammography plus breast MRI for some women at higher risk of breast cancer, including those with:

  A BRCA1 or BRCA2 gene mutation
  A first-degree relative with a BRCA1/2 mutation, but personally have not been tested for BRCA1/2 mutations
  A strong family history of breast or ovarian cancer (for example, two or more first-degree relatives with breast cancer or two or more with ovarian cancer)
  Radiation treatment to the chest area before age 30
  Li-Fraumeni, Cowden or Bannayan-Riley-Ruvalcaba syndrome (or a first-degree relative with one of these syndromes or family with a known p53 or PTEN gene mutation)
  A greater than 20 percent lifetime risk of invasive breast cancer

Certain women have a moderately increased risk of breast cancer. ACS and/or NCCN recommend that a woman at a moderately increased risk talk to her health care provider about the risks and benefits of screening with mammography plus breast MRI. Women who should consider mammography plus breast MRI include those who have:

  A personal history of invasive breast cancer or ductal carcinoma in situ (DCIS)
  A personal history of lobular carcinoma in situ (LCIS) or atypical hyperplasia
  Very dense breast tissue
  A 15 to 20 percent lifetime risk of invasive breast cancer

Talk with your health care provider about breast cancer screening. Together, you can come up with a screening plan that is right for you.

Breast Ultrasound

A breastultrasound uses sound waves to make a picture of the tissues inside the breast. A breast ultrasound can show all areas of the breast, including the area closest to the chest wall, which is hard to study with a mammogram. Breast ultrasound does not use X-rays or other potentially harmful types of radiation.

A breast ultrasound is used to see whether a breast lump is filled with fluid (a cyst) or if it is a solid lump. An ultrasound does not replace the need for a mammogram, but it is often used to check abnormal results from a mammogram.

For a breast ultrasound, a small handheld unit called a transducercamera.gif is gently passed back and forth over the breast. A computer turns the sound waves into a picture on a TV screen. The picture is called a sonogram or ultrasound scan.
Why It Is Done

Breast ultrasound can add important information to the results of other tests, such as a mammogram or magnetic resonance imaging (MRI). It also may provide information that is not found with a mammogram. A breast ultrasound may be done to:

  Find the cause of breast symptoms, such as pain, swelling, and redness.
  Check a breast lump found on breast self-examination or physical examination. It is used to see whether a breast lump is fluid-filled (a cyst) or if it is a solid lump. A lump that has no fluid or that has fluid with floating particles may need more tests.
  Check abnormal results from a mammogram.
  Look at the breasts in younger women because their breast tissue is often more dense, and a mammogram may not show as much detail.
  Guide the placement of a needle or other tube to drain a collection of fluid (cyst) or pus (abscess), take a sample of breast tissue (biopsy), or guide breast surgery.
  Watch for changes in the size of a cyst or a noncancerous lump (fibroadenoma).
  See how far cancer has spread in a breast.
  Check your breasts if you have silicone breast implants or dense breasts. In these situations, a mammogram may not be able to see breast lumps.