“Breast mammogram vs. breast ultrasound for tumors?”

Yes, mammograms are better, but if you feel a specific lump, then US is best for the lump.

Mammograms are currently the only recognized asymptomatic screening exam. Mammograms are recommended annually beginning at the age of 40 (ACR guidelines). Mammography has been recommended to start up to a decade before a 1st degree relative was diagnosed with breast cancer. US is an excellent supplemental exam for dense breasts. MRI is currently
recommended if there is a +20% lifetime chance of breast cancer. If a 35-year-old patient is symptomatic, then a diagnostic mammography and breast US should be ordered for initial evaluation.

In patients under the age of 40 a breast mammogram is the first exam ordered. And patience in this age group mammography is not considered until later because of the accumulative affect of radiation. So by standard of care and ultrasound is the appropriate first choice

It is ok to start with a mammogram. If any nodules or abnormalities are seen ultrasound may be helpful. Once you have this mammogram you should not have another one until you are 40.
Dr. Reed

Let the educated professionals order the correct test. You have a good doctor who knows what she is doing based on what little you have said in your question. There is no perfect test that finds every cancer. However, there is a methodical way of going about finding breast cancer that gives you the best chance of finding it. To do things in the wrong order puts you at risk for unnecessary biopsy. Mammography is the first step.

Ultrasound is good for looking at some things (determining if something is cystic (usually benign) or solid (higher risk for cancer) but ultrasound is not good at finding cancer as an initial test. It can miss a lot. If a lump is detected on a mammogram ultrasound can then determine if it is at risk for being cancer. However, a lot of densities that aren’t cancer may look similar under ultrasound. You wouldn’t want to chase every density on ultrasound unless it had a corresponding worrisome characteristic on a mammogram. You’d be biopsied unnecessarily. That is no picnic and not good practice. Additionally, ultrasound can miss cancers that present as a cluster of micro calcifications. For many reasons, ultrasound is a suboptimal screening tool for breast cancer.

MR can be used for screening if you are in a high risk category but it is not a good screening tool for a large group of woman at low risk for breast cancer. It is costly, may find false positives that are then biopsied unnecessarily.

There is no perfect test but you can select the best test for you based on your history. It sounds like your doctor has made good decisions on your behalf so far. Many health decisions you can and should make for yourself like diet, exercise and supplements. You should definitely discuss things with your doctor if you have questions, but LISTEN to their recommendations. Physicians dedicate years of their lives studying how to best help people preserve and manage health. Most physicians do not take that responsibility lightly. Sounds like yours is a keeper.

American Cancer Society has issued guidelines as follows:Women ages 40-44. Their choice to start annual mammography screening.Women ages 45-54. Should get annual screening mammograms.Women ages 55 and older should switch to mammograms every 2 years or may continue annually. At age 35, mammograms would not ordinarily be recommended unless there is a strong family history or signs or symptoms such as palpable lump, nipple discharge, pain/tenderness are present. Ultrasound of the breast is often utilized to determine if a mass or lump (often detected by mammogram) is solid or cystic.Some women at high risk may be screened with MRI as well as mammography.Sent from my Verizon, Samsung Galaxy smartphone

Breast ultrasound is good for women that have dense breasts as mammograms would fail to detect masses (which are usually dense) in women with dense breasts. Usually, breasts are more dense in younger women. If the classification of your breasts is dense or very dense, then you could definitely benefit from ultrasound. However, if you have not had a mammogram before, you would not know your breast density and mammography is definitely the first step. This is certainly the case for younger women like yourself that have either not had a mammogram or havr something palpable. Ultrasound is also usually either a followup for abnormal mammogram or normal mammogram in a woman with a palpable abnormality. It is not per-se a screening exam.

Hope this helps

Brian