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New York - Many radiologists encourage women to have ultrasound exams when their breasts are radiographically dense, or hard to examine on a mammogram.

A study in the current issue of JAMA reveals the pluses and minuses of that approach.

The investigators enrolled more than 2800 women, all of whom were at a somewhat increased risk of breast cancer and had dense areas in at least one breast.

The women then had mammograms and ultrasound exams.

Adding the ultrasound exam increased the number of breast cancer cases detected, and the researchers estimated that for every 1,000 women who had an ultrasound in these circumstances, another 1.1 to 7.2 cancer cases would be detected.

“Mammograms saw only half of the breast cancers that were present. If we added ultrasound to mammography, we saw 78 percent of the cancers,” said Dr. Wendie Berg of American Radiology Services at Johns Hopkins at Green Spring Station in Lutherville, Md.,  speaking to the New York Times.

On the down side, the number of false alarms–that is, the number of “things” that turned up on the screening exam, were biopsied, and found to be noncancerous–quadrupled.

Speaking to WebMD, Dr. Berg concluded: “The detection benefit of a single screening ultrasound in women at elevated risk of breast cancer is now well validated, but the high false positive rate and the lack of screening ultrasound for breast cancer will likely limit its role as a screening tool. There is a shortage of trained personnel, so if everybody decided tomorrow to use ultrasound to screen for breast cancer, that couldn’t happen.”