Is there an alternative to mammograms for younger women? Is screening with breast ultrasound or MRI an option?
Routine screening for breast cancer in women under age 40 is not generally recommended since the risk for breast cancer in this age group is very low. Among women who are being screened for breast cancer (high-risk younger women, and average-risk women aged 40 and over), breast sonography (ultrasound) is generally used to complement mammography rather than replace it. The sonogram can help determine if a breast abnormality seen on mammogram or detected during physical examination is cystic (and thus, more likely benign) or solid. Breast sonography is not generally considered to be as good a mammography as a single test for breast cancer screening.
Breast MRI is a very sensitive breast imaging technique. That means that it is very good at finding any abnormality — including many benign ones. The problem in performing breast MRI on everyone is that it finds too many things. If breast MRI were used instead of mammography, there would be so many false positive MRIs that far too many women would be having biopsies of benign breast findings. Breast MRI is not generally recommended as a sole screening test for women at average risk of breast cancer. In women in the very high-risk category (for example, women who are known to carry a mutation in the BRCA-1 or BRCA-2 gene that predisposes to breast cancer) breast MRI is recommended for use in conjunction with mammography.