Three main tools are used for the early diagnosis of breast cancer: mammography, which is an X-ray of the breast, manual breast examination, and breast ultrasound. Among them, mammography is the primary tool for monitoring. It is an available and efficient test for detecting small growths that are difficult or impossible to detect through manual examination. However, the accepted recommendation is not to perform this test on young women (under the age of 40-50) except in special situations with a particularly high risk of developing breast cancer at a young age. Additionally, about 15% of cancerous growths are missed in mammography. Therefore, manual examination is essential in younger ages when mammography is not used, and it serves as a complementary test to mammography in older ages.
Until a few years ago, breast ultrasound was used to characterize findings detected in manual examination or mammography. Nowadays, ultrasound serves as a complementary tool to mammography in early detection tests, as described below.
Breast MRI is a relatively new method that is already in clinical use and offers a high-powered tool for early detection, especially in young women and particularly in carriers of mutations in the BRCA gene. The MRI test is funded only for mutation carriers. The test is still in the learning process. Its availability is low, and the waiting time, even in cases of suspected growth, can be lengthy.
The main advantage is its very high sensitivity, even in cases where mammography is less effective, such as in young women. However, in contrast to mammography, breast MRI can assign a higher degree of suspicion to findings that are not malignant.