What is the most effective breast imaging method? I have had breast cancer in the past. What is the most reliable imaging method for follow up check ups? I'm concerned that something might show up in one type of test, but not another.

A. A diagnostic mammogram is generally the recommended imaging modality for follow-up in a patient with prior breast cancer. No screening exam is perfect when it comes to detecting recurrent breast cancer, but mammography is generally considered the most sensitive test. Eventually MRI could replace mammography in this role, but breast MRI has multiple limitations which prevent it from being the screening exam of choice at this time. First, it is extremely extensive and having a breast MRI every 6 to 12 months is usually not economically feasible for the patient. Second, the technology is relatively new and most breast imagers are more familiar with and effective at using mammography for screening. Breast ultrasound is not an adequate screening when compared with mammography, but it can be used when additional imaging is needed.
Mammogram. Mammography is still the gold standard for breast cancer screening.
No best test. If you had a lumpectomy, you should get followup breast imaging. Mammography and a breast exam should be included. Whether ultrasound or MRI would be helpful needs to be discussed with your doctor and depends on a number of factors including how your prior tumor was found, breast density, etc.