What is the best imaging modality for breast cancer screening?

• A. Mammography
• B. Ultrasound
• C. MRI
• D. CT

Answer: (A)

Mammography is the best imaging modality for routine breast cancer screening because it is specifically designed to detect early cancers in asymptomatic women in a practical, cost-effective way. Low-dose X-rays can reveal small masses and, importantly, microcalcifications that often signify early ductal changes before a lump forms. Large population studies have shown that regular screening with mammography reduces breast cancer mortality, reinforcing its role as the standard screening tool.

Ultrasound has important clinical uses, such as evaluating a suspicious area found on mammography or guiding biopsies, and it can help in women with very dense breasts. However, it is not used alone for routine screening because it misses many cancers that mammography picks up and its effectiveness depends on the operator.

MRI is extremely sensitive and can detect cancers missed on mammography, which is why it’s favored for high-risk individuals or for problem-solving cases. Its high cost, limited availability, and tendency for more false positives make it unsuitable as a general screening test for average-risk women.

CT is not used for breast cancer screening due to higher radiation exposure and its lack of utility in detecting microcalcifications, making it inappropriate as a screening modality for the breast.