In dense breasts, which imaging modality best complements mammography to evaluate a suspicious lesion?

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Dense breast tissue makes mammography less sensitive because overlapping fibroglandular tissue can hide or mimic lesions. Ultrasound complements mammography by using sound waves to evaluate the area of concern without being hampered by tissue density. It can distinguish solid from cystic lesions, assess margins and internal characteristics, and guide biopsies, which helps clarify whether a suspicious finding on mammography is benign or worrisome. While MRI can be very sensitive, it isn’t the first-line adjunct due to cost, availability, and higher false-positive rates; CT and nuclear medicine provide less specific soft-tissue detail for evaluating breast lesions. Thus, ultrasound is the best complementary modality in dense breasts for evaluating a suspicious lesion.