"The Girls" in 3-D

We’ve shared a lot at MiddlesexMD about all things breast cancer—diet, lifestyle choices, risk factors, treatments—just to name a few. So, is there anything new to discuss?

Actually, yes.

The rate of breast cancer goes up as you get older.

You may have heard about the more advanced 3-D mammograms that were approved by the FDA in 2011 are now available in many medical facilities. Often referred to as “breast tomosynthesis” (or tomo, for short), 3-D mammograms show multiple images of the breast tissue. These images are typically called "breast slices" and are taken at different angles. Traditional mammography shows just a single image.

Tomosynthesis offers a number of advantages over the traditional 2-D tests:

  • Provides a clearer image of a mass.
  • Makes it easier to detect breast cancer.
  • Allows doctors to find the cancer early.
  • Reduces the chances of a false positive, that is, seeing an “area of concern” in a normal breast.
  • Improves the chances finding dangerous cancers.
  • Reduces the number of repeat tests, the need to return for another mammogram or ultrasound.

Even better, these advanced tests pose no greater risk to patients than regular mammograms—both the traditional mammogram and the 3-D mammogram are very low in radiation exposure (and there’s no increase of exposure with the 3-D technology). The technique used for both types of mammograms are basically the same, with the 3-D tests lasting only a few seconds longer.

Though there are some drawbacks, the benefits make it the better choice for some women. Those who benefit the most are those with dense breasts, with a family history of breast cancer, who’ve had frequent call-backs after traditional mammograms, or who’ve had chest-wall radiation (as treatment, for example, for Hodgkin’s lymphoma).

Here are the few drawbacks of 3-D mammograms:

  • Not all hospitals or mammogram centers have this type of screening available, because it’s not yet considered the standard of care for breast cancer screening.
  • They are more expensive than standard mammograms.
  • They may not be covered in full by some insurances; check with your provider before you schedule your test to avoid surprises.

Research supports the value of 3-D mammograms. As with any new technology, it takes some time to understand the long-term benefits. One study that compared results over three years found that cancer detections were more successful with the 3-D screenings, and that the rate of recalls (for additional testing) went down when the 3-D mammogram was used in successive years.

"These findings reaffirm that 3-D mammography is a better mammogram for breast cancer screening," said Emily Conant, MD, chief of breast imaging at the Perelman School of Medicine at the University of Pennsylvania, who was the senior author of the study. "These results are an important step toward informing policies so that all women can receive 3-D mammography for screening."

The hope is that results like these may help 3-D mammograms become the norm and covered by all insurance companies.

I always advise my patients (and all women for that matter) to schedule a yearly mammogram, and I encourage everyone to consider having a tomo test done for your next mammogram. Be sure to check with your insurance company to see what type of coverage you have; if you are able to have it done, please do. The results are encouraging and can be helpful for all women!


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