In dense breasts where mammography is inconclusive, which imaging modality is commonly used to further evaluate a lesion?

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Dense breast tissue can mask findings on mammography, making it hard to tell if a lesion is benign or malignant. Ultrasound is the next step because it uses sound waves and isn’t hindered by density, giving a clear real-time view of the lesion. It helps determine whether the lesion is solid or cystic, assesses margins, and can guide biopsy if needed. While MRI is very sensitive, it’s more expensive and typically used in specific scenarios rather than as the routine next test. CT and X-ray (mammography) offer less soft-tissue detail for breast lesions and involve radiation (to a greater extent with CT). So ultrasound is commonly used to further evaluate a lesion in dense breasts when mammography is inconclusive.