What is the role of ultrasound in evaluating a suspicious mammographic finding in dense breasts?

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In dense breasts, ultrasound serves as a valuable complement to mammography by providing real-time characterization of a suspicious finding. Its main strength is distinguishing solid from cystic lesions, which directly informs management—cysts may be observed or drained, while solid masses often require tissue biopsy. Ultrasound can also guide biopsy with precise needle placement if indicated, improving diagnostic accuracy. It does not replace mammography; instead it adds detail where density limits mammographic sensitivity. Since ultrasound uses sound waves, it does not increase radiation exposure, making it a safe option for further evaluation when a finding is suspicious on mammography.