With a mammogram is it normal to have to have an ultrasound? i cannot afford it.

Sometimes: Not all radiographic testing is 100% diagnostic. Sometimes you need additional testing to see areas of the breast more clearly. I would discuss this with your physician if they fell that the ultrasound is necessary. If it was me, i would want everything possible to do a full evaluation.

Very common: Especially if you or your physician were able to feel something, ultrasound is frequently requested following a mammogram, even if the mammogram is normal. If the mammogram is abnormal, the ultrasound will be important in planning/doing a biopsy if needed. It would be money well spent.

Sometimes: It is relatively common to use ultrasound to further evaluate mammographic findings. Perhaps if you talk to the imaging facility manager they can do something to accommodate your financial status.