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Shadow on mammogram, not on ultrasound?

Page last modified on: October 13, 2008
Question from MaureenT: Why would a shadow show on a mammogram and not be seen on an ultrasound? I also had a lump that I could feel not show up on ultrasound.
Answer —Beth DuPree, M.D., F.A.C.S.: A mammogram is a two-dimensional X-ray of the breast, which may show dense tissue in the breast that when an evaluation is followed up with ultrasound may fail to demonstrate a specific area of concern on the ultrasound. That does not mean that the mammographic density is less of a concern. It could mean that a biopsy of that region would require mammographically guided biopsy techniques to obtain tissue from that region that was abnormal on the mammogram. A lump that is felt or palpable in the breast can exist and still not be able to be shown as a separate area on an ultrasound. That does not mean that the mass has no clinical concern. It means that the area would potentially need to be biopsied, based solely on the fact that it is a region that is concerning on clinical exam. One of our greatest pitfalls in the diagnosis and treatment of breast disease is that no one test is able to find every cancer. Therefore, we rely on mammography, ultrasound, MRI, and physical diagnosis to help us during the time of the workup of a lesion found by any of the above means.

On Wednesday, September 20, 2006, our Ask-the-Expert Online Conference was called Open for Your Questions. Ruth Oratz, M.D., F.A.C.P. and moderator Beth Baughman DuPree, M.D., F.A.C.S. answered your questions covering a wide variety of issues relating to breast cancer.

The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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Meet the Experts

Ruth Oratz, M.D., F.A.C.P.Ruth Oratz, M.D., F.A.C.P. is associate professor of clinical medicine at New York University School of Medicine. She is the founder of The Women's Oncology & Wellness Practice in New York City where she specializes in treating women with breast cancer and other malignancies, as well as women at risk for cancer. 

Beth Baughman DuPree, M.D., F.A.C.S.Beth Baughman DuPree, M.D., F.A.C.S. is a general surgeon. Her clinical practice is located at Holy Redeemer Hospital and St. Mary Medical Center.

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