Many women are confused about why I should have a mammogram after an ultrasound. Is mammography more advanced than ultrasound? How should I choose? In fact, ultrasound and mammogram have their own advantages and disadvantages and complement each other, depending on the patient’s disease condition. Let’s take a closer look at them. Ultrasound mainly identifies lumps and is less sensitive to small calcifications Ultrasound advantages: 1) ultrasound of the breast is not radioactive and can be repeatedly examined as needed; 2) ultrasound can clearly distinguish levels, and the accuracy of identifying cystic (cystic nodules with fluid inside) and solid lumps can reach 100%, which can roughly determine the benignity and malignancy of the tumor; 3) ultrasound can guide puncture biopsy; 4) ultrasound can also understand the lymph nodes in the axilla and supraclavicular area. There is no metastasis. Disadvantages of ultrasound: ultrasound is difficult to distinguish many tiny calcified foci. Some people may ask, “What if ultrasound is not sensitive to “calcification”? Why do we have to use mammography to look at it again? It is because malignant calcification is the main manifestation of cancer, and microcalcifications in clusters, mud-like, rod-like, or branch-like foci often indicate the possibility of breast cancer. However, there is no need to be nervous when you see calcifications, as malignant “calcifications” are very rare, but a clear diagnosis is necessary just in case. Mammography mainly looks at calcifications and can easily miss masses. Advantages of mammography: Mammography has the most advantages in detecting small calcifications, which in turn can detect asymptomatic or untouchable tumors, and is even more efficient than MRI. Disadvantages of mammography: ①Mammography is a flattened fluoroscopy of the whole breast, so if the patient has abundant breast glands, the glands will overlap with the lesion, making it difficult to distinguish between the gland and the lesion; ②If the breast volume is small and the lump is close to the chest wall, it cannot enter the fluoroscopic range, resulting in no inspection and easy to miss; ③Mammography is somewhat radioactive and is not suitable for frequent inspection; ④Some patients report that it is painful when taking mammography. Because 5~7 days before a woman’s menstrual period, her breasts will be swollen and painful, and it will naturally be more painful to do mammography at such a time when the pressure plate is clamped on the breast. Therefore, it is most appropriate to do the examination about 10 days after the menstruation is clean, and the pain is usually not unbearable. Some patients also ask what is the purpose of infrared examination of the breast. In fact, infrared examination is only of reference value, it is not very sensitive and specific, so it is not suitable for screening of breast diseases. When should I have an ultrasound? When should I have a mammogram? When should both be done? 1. Ultrasound only: Ultrasound is the first choice for breast screening in young people. It is generally recommended that women over the age of 35 have an ultrasound examination of the breast once a year. 2. Mammography only: For women over 60 years old, the glands have started to shrink and there is no need to worry about overlapping glands, so it is okay to check only one mammography at this time. 3.Both tests should be done: ①Suspicious lesions (such as suspected malignancy) are found after having an ultrasound and need further confirmation; ②The examiner is over 40 years old and has never had a mammogram before, then the doctor will also recommend a mammogram screening. 4, which test can see the lesion, which test will be used for follow-up: ① Some patients have a mammogram and find a suspicious lesion, but it is not obvious under ultrasound, then the mammogram should be the main test for follow-up. Generally, if the mammogram is performed no more than twice a year, the radiation level will not exceed the standard; ② If the patient’s lesion can be seen with ultrasound, but cannot be found with mammogram, then ultrasound is the main test to be used in the follow-up.