Introduction This study is a preliminary retrospective analysis of a new imaging technique, sonographic tomography, for the determination of the exact extent of disease prior to definitive surgery for breast cancer. Materials and methods Forty-one women were diagnosed with breast cancer had preoperative staging using sonographic tomography, between August 2007 and June 2008. All these women subsequently underwent bilateral contrast-enhanced MRI prior to surgery to determine if there were areas of tumor extension, multifocality, axillary adenopathy, or contralateral disease that would affect their planned surgery. Both imaging techniques were then compared retrospectively for accuracy to pathologic truth. Results Sonographic tomography accurately staged breast cancer preoperatively in 68% of cases, while MRI did so in 54% of cases. The resulting improvement in overall accuracy is 14% (2–28%). Sonographic tomography appears non-inferior to contrast enhanced, bilateral breast MRI. Conclusions Further, prospective, study is needed to further evaluate this new imaging technique in preoperative staging prior to definitive surgery.