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Evidence to Improve Care

Ultrasound as an Adjunct to Mammography for Breast Cancer Screening


Ontario Health Technology Advisory Committee Recommendations

  • The Ontario Health Technology Advisory Committee recommends publicly funding screening breast ultrasound as an adjunct to screening mammography for high-risk women in whom magnetic resonance imaging (MRI) is contraindicated

  • The Ontario Health Technology Advisory Committee recommends against publicly funding screening breast ultrasound as an adjunct to screening mammography in women at average risk for breast cancer

Read the full OHTAC Recommendation report



Breast cancer is the most common cancer in Canadian women. Screening for breast cancer is the process of looking for the disease before symptoms arise so it can be treated early.

In Ontario, mammography (a low-dose x-ray) is used to screen women at average risk for breast cancer. Women at high risk for breast cancer should be offered an adjunct (additional) test with magnetic resonance imaging (MRI).


Health Quality Ontario Reviews Ultrasound Screening as an Adjunct to Mammography for Breast Cancer Screening

Ultrasound is an imaging method that uses sound waves and can be used to look for breast cancer missed by mammography. Although ultrasound might detect more potentially harmful cancers, it might also increase the frequency of false-positive test results (test results that incorrectly indicate that a particular condition is present). False-positive test results can lead to anxiety and unnecessary follow-up testing.

Health Quality Ontario examined the impact of ultrasound as an adjunct test to mammography for breast cancer screening in women at average risk and at high risk for breast cancer. We also researched patient experiences of inaccurate breast cancer screening results.


Ultrasound as an Adjunct to Mammography for Breast Cancer Screening: A Health Technology Assessment (PDF)
July 2016

Women’s Experiences of Inaccurate Breast Cancer Screening Results: A Systematic Review and Qualitative Meta-synthesis (PDF)
July 2016


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The Ministry of Health and Long-Term Care has accepted this recommendation.

The Ministry of Health and Long-Term Care has provided the following response: Health Quality Ontario’s recommendation aligns with the current standard of care delivered and funded through Cancer Care Ontario’s Ontario Breast Screening Program.




Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee (OHTAC) — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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