Mammography and breast ultrasound are two of the most common and useful screening methods in breast surgery. So which one should we choose when we have a normal exam? Or is it safer to do both after all? In fact, ultrasound and mammography are two completely different examinations; ultrasound has its own advantages in evaluating the local microstructure and mammography has its own advantages in screening breast cancer, and they can complement each other in many aspects. For example, mammography is more sensitive to calcified foci, while ultrasound has a unique advantage in the diagnosis of cysts. The features and differences of these two tests are described in detail below. 1. Mammography The use of mammography was a landmark event in breast surgery. Thanks to the wide application of mammography, a large number of early breast cancers without clinical symptoms were detected earlier and the death rate of breast cancer population was greatly reduced as a result. Mammography has unique advantages for early stage breast cancers, especially those without masses, which appear only as calcified spots or distorted local structures on mammography. In clinical practice, mammography is an important tool for breast cancer screening, and annual mammography is recommended for women over 35 years of age. For patients with confirmed or suspected breast cancer, mammography of both breasts can help detect multiple or bilateral breast cancers. Regular mammograms are also needed after treatment for benign and malignant disease. Mammography can also be used to locate biopsies of lesions that do not have clinical masses (such as calcified foci). Under mammography surveillance, a localizing guide wire is placed near the lesion and the lesion is accurately removed intraoperatively according to the position of the guide wire, reducing trauma while improving diagnostic accuracy. The radiation dose of mammography is very low, but for women under 35 years old who are at high risk of breast cancer due to the dense breast tissue, it is generally recommended to undergo mammography once a year. Ultrasound has a unique advantage in the diagnosis of breast cysts. The examination of the axillary and supraclavicular lymph nodes is also a strong point of ultrasound. An experienced ultrasonographer is able to detect those tiny tumors that are not reachable. Puncture localization or biopsy of microscopic lesions under ultrasound guidance has become an important tool in breast surgical biopsy, greatly improving accuracy and reducing the number of open surgeries, while many such lesions do not show or do not show up on mammograms. Currently, many studies have shown that because Asian women have dense breast tissue and the age of onset of breast cancer is earlier than that of Westerners (the peak incidence of breast cancer in Europe and the United States is after menopause, the breast tissue is atrophic and thin, and the lesions are more clearly shown on mammography; while the peak incidence of breast cancer in Asians is before menopause, at the age of 40-45, the breast tissue is dense and the lesions are less well shown on mammography), B ultrasound is showing an increasingly important role in breast cancer screening and diagnosis. B ultrasound has shown an increasingly important role in breast cancer screening and diagnosis. One more point to emphasize is that due to its operational characteristics, ultrasound examination results are highly dependent on the machine and the doctor’s experience, and there is a certain rate of missing and misdiagnosis (in fact, this is true for any examination), which is normal. Therefore, we should not be superstitious about the examination, but should combine the physical examination and these auxiliary examinations for comprehensive evaluation, and also need regular review and follow-up. Only in this way can we improve the diagnosis rate of early breast cancer, thus, further improve our treatment effect and patient’s prognosis. 3, early detection of breast cancer B ultrasound + molybdenum palladium X-ray is the most reliable The five-year survival rate of stage I breast cancer is over 90%, stage II 80%, and stage III 60%. Therefore, it is necessary to have regular breast examination and early detection of breast cancer. Whether young or old, it is best to have regular checkups if possible, to actively treat breast diseases, and to develop good living and eating habits to prevent the disease before it happens. The breast self-examination has been promoted by looking at the shape, feeling the touch and squeezing the overflow. However, advocating ultrasound, molybdenum-palladium X-ray, MRI and other examinations, breast self-examination is feasible, but not a critical screening method. If abnormalities are found, one should also go to the hospital for examination as early as possible. For Oriental women with small breasts and dense mammary glands, color ultrasound should be the mainstay, supplemented by mammography, and color ultrasound should be used every year until the age of 40, followed by mammography after 40. If no problems are found with both color ultrasound and molybdenum palladium radiographs, they can be examined again in two or three years with molybdenum palladium.