Breast cancer (BC) screening is significantly important for reducing disease mortality. In much of Asia and other low income countries (LMIC) breast cancers are typically discovered by the woman herself or found on clinical breast exam (CBE) by community health workers and often are late stage at the time of diagnosis. In most LMICs, community health workers and primary care providers lack sufficient knowledge and skills regarding breast cancer diagnosis to perform CBE. Mammography (MAM) is the gold standard for BC screening in high-income countries, while it is usually unavailable and infeasible in low- and middle-income countries (LMICs). Ultrasound (US) has been widely employed as an adjunct to MAM, particularly showing advantages over MAM for women of younger ages and with dense breasts. Nevertheless, it remains controversial whether US could be utilized as a primary tool for BC screening in underserved settings. However, the evidence on the effectiveness of ultrasound screening in population-based cancer screening program in lacking. There is no organized, systematic, government funded screening program for breast cancer in Bangladesh. This study is carried out as part of a research project on breast cancer to find out the healthy control women at the community level this year. Women were preselected matching with age and socioeconomic status of our breast cancer patients. They were enrolled between age group 40 to 50 years. Every women were subjected to physical examination, USG examination by a hand held USG device by expert breast surgeons. Among 445 women examined, fifteen women were found to have some suspicious lesions in their breast. Clinical examination missed this finding. Five of them confirmed as invasive cancer. It proved to achieve cost-effective screening initiatives where MAM is not available. The resource-appropriate recommendations on implementing BC screening in LMICs including Asian countries to be discussed for further recommendation.