3D Mammography: Coming Soon to a Hospital Near You?

PJ Hamel Health Guide
  • A new type of mammography has been making its way into hospitals and health centers for the past several years. Is it available where you go for your mammogram? And, if so – is it right for you? 


    Do you dread your yearly mammogram? Do you dislike the pain, the waiting for results, the angst around possible callbacks? Add to this the knowledge that mammograms aren’t completely accurate – and less so for women with dense breasts – and the whole experience can feel rather discouraging.


    Well, there’s a new screening technology for breast cancer that results in fewer needless callbacks, and identifies more cancers, sooner. Called digital tomosynthesis (a.k.a. 3D mammography), when used in concert with traditional 2D mammography it’s an easier, clearer way to screen for breast cancer.

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    And it could potentially save your life.


    The traditional mammogram sends X-rays through your breast, recording results either on film or in digital format. The radiologist then examines the film (or computer image), looking for solid masses that aren’t normal tissue nor fat, masses that show up white or light gray on the image. 


    With 3D mammography, the breast is X-rayed from s series of different angles, and then all of the data is reconstructed digitally into a 3D image, giving the radiologist a much clearer and more thorough view of your breast.


    Imagine riding in a plane above a forest. Now imagine standing on the forest floor, and looking up, down, and all around you. That’s the difference between 2D and 3D mammography.


    Since the technology started appearing in clinical trials over 10 years ago, radiologists have felt that 3D mammography would soon prove its worth; and this past summer their opinions were justified. A study spanning 3 years, and covering 455,000 screenings at 13 different facilities, showed that 3D mammography combined with traditional 2D resulted in 29% more cancers being identified, as well as a 15% reduction in callbacks, compared to 2D alone.


    Radiologists report that 3D mammography gives them a better, clearer view than 2D. With traditional mammography, scar tissue, a fold of compressed flesh, or other normal parts of the breast can appear suspicious, calling for additional views and/or tests. With 3D, it’s easier for radiologists to either rule out an anomaly without a callback; or rule it in, necessitating a biopsy. Either way, the woman endures less uncertainty, less waiting, and fewer additional tests.


    3D mammography should prove especially valuable for women with clinically dense breasts. It’s estimated traditional mammograms are only about 50% effective for these women, since the white appearance of a solid mass detected by X-ray can easily be hidden by the same white appearance of normal fibrous and glandular tissue. 


    With 3D mammography, it’s easier to identify an abnormal solid mass within normal tissue, based on location and shape. Since women with dense breasts are up to six times more likely to be diagnosed with breast cancer than the average woman, this is a huge step forward in identifying cancer early.


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    In addition, 3D/2D mammography has been shown to be more effective than 2D alone at identifying small invasive tumors and lobular cancer, both of which are often more dangerous than more standard cancers.


    While the technology is still too new to assess whether its capacity for early detection of cancerous tumors actually saves lives, 3D mammography is definitely a step up from traditional mammography. 


    And while it’s not yet available everywhere, and is less likely than a standard mammogram to be covered by insurance, it’s worth asking your doctor about it next time your yearly mammogram comes due. Especially if you have dense breasts, or are prone to callbacks, 3D mammography is probably your better choice.



    Digital Tomosynthesis. (2013, August 21). Retrieved October 24, 2014, from http://www.breastcancer.org/symptoms/testing/types/dig_tomosynth


    Friedewald, S. (2014, June 25). Breast Cancer Screening Using Tomosynthesis in Combination With Digital Mammography. Retrieved October 24, 2014, from http://jama.jamanetwork.com/article.aspx?articleid=1883018


    Hamel, P. (2008, March 20). Digital Tomosynthesis: Another Possible Mammogram Replacement for Breast Cancer Diagnosis? Retrieved October 18, 2014, from http://www.healthcentral.com/breast-cancer/c/78/22264/mammogram


    Healy, M. (2014, June 24). 3D mammograms improve breast cancer detection, drive down false alarms. Retrieved October 24, 2014, from http://www.latimes.com/science/sciencenow/la-sci-sn-3d-mammograms-breast-cancer-20140624-story.html


Published On: October 28, 2014