Which imaging modality is best for screening breast cancer and detecting early cancer and microcalcifications?

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

Answer: (C)

Mammography is the screening modality best suited for detecting early breast cancers and microcalcifications. It uses low-dose X-rays designed to reveal tiny calcifications and subtle masses that may indicate ductal carcinoma in situ or early invasive cancers. This capability to visualize microcalcifications makes it particularly effective for catching cancers before they become palpable. Mammography has been proven in population studies to reduce breast cancer mortality, is cost-effective, and is widely accessible, making it the standard screening tool.

Other imaging methods have important roles in specific situations but are not ideal for routine screening. Ultrasound is excellent for evaluating a known lump or guiding biopsies, but it misses microcalcifications and is less effective in dense breasts for screening. MRI is highly sensitive and useful for high-risk populations, but its use as a general screening test is limited by cost, availability, and higher false-positive rates. Tomosynthesis (3D mammography) can improve detection and reduce recalls in some cases, but conventional mammography remains the cornerstone for screening and identifying early microcalcifications.