【Breast Cancer Part 2】Mammogram vs Ultrasound: Here's The Real Difference, How To Choose & How To Interpret Your Reports, Explained by Cancer Specialist
- drteoyinkeong
- Oct 10
- 5 min read
Updated: Oct 13
Johor Bahru, Malaysia
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Many women are aware of the importance of regular breast screening. The two most common breast screening methods are the mammogram (breast X-ray) and the breast ultrasound. However, many are unsure about how these two tests differ.
Common misconception includes:
🔴 “Younger women only need ultrasound.”
🔴 “Mammograms are only necessary after 40.”
🔴 “Ultrasound is cheaper, maybe that's enough for me.”
‼️ These statements make it seem like your age or budget determines the right screening test — but that’s a big misconception.
Key Differences You Should Know About Mammogram vs Ultrasound Breast Cancer Screenings
In short, a mammogram and an ultrasound are not meant to replace each other or be treated as an “either-or” choice. They are complementary tools — when used together, they provide a clearer and more comprehensive picture for accurate diagnosis.
⚠️ Common Misconception!
Is mammogram only for women aged 40–60?
That’s what many people think, but it’s not true! Breast cancer risk does increase after 40, which is why mammograms are more commonly recommended at this age. Mammogram can detect tiny changes in breast tissue even before a lump forms. After 40, breast tissue also becomes less dense, making mammogram images clearer and easier to interpret.
💡 Did you know: After 60, breast tissue further deteriorates and becomes even thinner. At this stage, ultrasound or physical examination can usually detect most abnormalities, so higher resolution scans such as mammograms may no longer be necessary.
‼️ The need for a mammogram or ultrasound doesn’t depend on age alone. Age is just one factor — doctors also consider your breast density, symptoms, and overall risk profile to decide the most suitable breast screening test.
After The Scans, How Do You Read Your Mammogram and Ultrasound Report? What the Results Really Mean?
During your consultation, your doctor will usually explain your imaging report and advise you on the next steps. However, in a busy clinic setting, not every doctor has the time to go through every detail of the report. That’s why it helps to know a few key questions to understand your results more clearly and communicate better with your doctor.
These are the 3 important questions you can ask. Even without a medical background, these will help you quickly grasp the key points in your breast screening report.
1️⃣ Doctor, did you find any lump in my breasts (left or right)?
No lump: In most cases, that’s a good sign. Don't have to be too worried.
Yes, there is a lump: The next step is to determine whether it’s benign (non-cancerous) or malignant (cancerous). Move on to Question 2.
2️⃣ Doctor, what is the BIRADS score of my lump?
BIRADS (Breast Imaging Reporting and Data System) is an international grading system used to assess the risk level of a breast lump. In simple terms, it helps indicate whether the lump shows any suspicious features that may need further investigation.
💡 Tip: If your doctor only says “Everything seems fine” but you still feel uncertain, don’t hesitate to ask: “Could you tell me what's my BIRADS score?”
3️⃣ Doctor, are there any enlarged lymph nodes under my armpit?
No enlargement: This usually means there are no signs of cancer spread.
Enlarged lymph nodes: The next step is to check whether they have a fatty hilum (fatty centre).
With fatty centre: Usually benign or due to inflammation.
Without fatty centre: May require further tests to rule out cancer spread.
⚠️ Reminder: Lymph node findings on imaging can be subjective. They only suggest the possibility of spread. A biopsy is still needed to confirm whether cancer has actually spread.
Breast Ultrasound and Mammogram
help detect warning signs, but only a biopsy can truly confirm cancer.
Many people think that doing an ultrasound and mammogram is enough to confirm whether they have breast cancer, but that’s not true. These two tests can only assess your risk, not make a definite diagnosis.
To confirm cancer, a biopsy (tissue sampling) is required.
Some early-stage breast cancers don’t even form obvious lumps. They may only show up as tiny calcium spots or lymph node changes.
In some cases, your doctor may also suggest an MRI or other follow-up tests to ensure nothing is missed.
Doing your regular breast scans is just the first step; knowing what to do next makes the real difference.
As an oncologist, I often remind patients: the key to breast screening isn’t just about doing the test. It is also about understanding your results and knowing what to do next.
Whether you’re in your 30s or 50s, remember this:
Ultrasound and mammogram complement each other. They are not substitutes. A “normal” result from just one test doesn’t always mean everything is fine.
Take initiative to understand your report, "normal" isn't always normal.
Biopsy remains the only way to confirm cancer, when needed.
Only when you truly understand your results and follow through with the right next steps does breast screening become meaningful.
👉 Tip: If you’re unsure about your results or which test is right for you, consult a breast surgeon or oncologist. Ask specific questions, it helps you get clearer, more useful answers.
Cancer / Oncology Care Brought To You By
👨⚕️Dr Teo Yin Keong
Clinical Oncologist, Johor, Malaysia
©️ TEOncology
