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Background: Space radiation can cause different types of cancers in crewmembers, especially during long-term space missions. Introduction: To date, a complete bilateral breast ultrasound has not been performed at the International Space Station (ISS). A breast screening imaging technique could be a useful tool for early identification of breast cancer in astronauts. We hypothesized that breast ultrasound performed by a crewmember while being remotely guided by a specialist from the ground could be an essential tool for medical diagnosis in space. This project aimed to test an ultrasound screening protocol for breast tissue using real-time remotely guided telemedicine techniques. Materials and Methods: One female volunteer, with no previous medical experience, performed a self-scanned bilateral breast ultrasound exam guided by a remote sonographer. Dynamic ultrasound images were collected using a 25 mm broadband linear array transducer. To simulate fluid shift on the volunteer during microgravity, the bed was tilted −6°. Results: Recorded ultrasound images were analyzed by radiologists, comparing the findings with a gold standard. The experiment demonstrated that real-time remotely guided sonography exam is feasible and can yield meaningful clinical results. Discussion: This case study showed that remotely guided breast ultrasound can be performed and might become an important tool for diagnosis of breast cancer in space missions. Conclusion: The results cannot be generalized based on one subject, and additional research is warranted in this area in addition to its validation on the ISS. This technique, however, has potential for use as part of preventive medicine procedures for long-term space missions at the ISS, and eventually for human settlements on the Moon and Mars. [ABSTRACT FROM AUTHOR]