Introducing Digital Mammography’s New 3D Friend: Tomosynthesis

How does it work?

Similar to a CT scan, tomosynthesis creates multiple images or “slices” that step through the breast tissue, which allows the radiologist to see greater detail and helps reduce the impact of overlapping breast tissue. It will offer better visualization for radiologists who are helping certain groups of patients—particularly those who have dense breasts.

Yes, ladies, compression is still a must! A 3D mammogram exam is very similar to a 2D mammogram—both are performed together on the same scanner. Just as with a digital mammogram, the technologist will position you, compress your breast under a paddle, and take images from different angles. During the 3D portion of the exam, the x-ray arm of the machine makes a quick arc over the breast, taking a series of breast images at a number of angles. The entire procedure should take approximately the same amount of time as it had before.



How could you benefit?

  • Less likely to be called back. Tomosynthesis allows radiologists to look at different layers of the breast tissue, helping to distinguish normal breast tissue from abnormal breast tissue. Information from these additional views is believed to lead to fewer callbacks and, therefore, less anxiety for women.
  • Easier to see. Radiologists can better determine the size, shape and location of an abnormality with tomosynthesis.
  • Earlier detection. By minimizing the impact of overlapping breast tissue, tomosynthesis may improve breast cancer screening and early detection.

To provide an example…if a 2D mammogram shows an area of concern, radiologists may want to further investigate with a diagnostic mammogram, ultrasound or biopsy. Looking at the same breast tissue in 3D, the radiologist may now see that the tissue is in fact normal breast tissue that was simply overlapping in the 2D mammogram, creating the illusion of an abnormal area. In this scenario, you would likely avoid a callback for an additional mammogram.

Keep in mind…although the the likelihood you’ll be called back may be less does not mean it’s not possible. There is still a chance that you may require additional mammographic views and/or ultrasound.


Is tomosynthesis right for you?

All women may benefit from tomosynthesis; however, the benefit is greatest in women with dense breast tissue, because it can mask cancers and/or lead to false positives.

It is an optional service for the patient, which supplements the conventional mammographic images. It’s important to know that 2D digital mammography still remains the gold standard for early detection and is still the most important tool in the diagnosis of breast cancer.  3D images simply offer better visualization for radiologist and in turn hopefully decrease the need for a call back and additional studies.


How do you know if you have dense breasts?

Density refers to breasts with more glandular and connective tissue than fat—not breast firmness—so a mammogram is the only way to find out about density. You can either:

  • Speak with your physician. If you have had a prior mammogram, your primary care provider will have a report on record that would indicate your breast density, or
  • Speak with your mammography provider. If you have had a prior mammogram, your mammography provider will have a report on record that would indicate your breast density.


What about radiation?

The radiation dose is approximately the same for tomosynthesis as it is for traditional 2D mammography. So the radiation is roughly doubled when doing a 2D mammogram along with tomosynthesis. Charlotte Radiology explained that even this combined dose is still below the FDA-regulated limit for 2D mammography and has been found by the FDA to be safe and effective for patient use.

To put radiation into a little bit of perspective…when a patient receives a 2D mammogram she will pick up the amount of radiation that would be received in a flight from Charlotte to LA. With 3D, it would be equivalent to flying from Charlotte to LA and then back to Charlotte – all due to the increase in altitude and impact from the sun’s radiation.


What’s your cost?

For most, insurance does not yet cover the tomosynthesis portion of the mammogram. However, the 2D portion of the exam is covered 100 percent by most plans. Depending on your mammography provider, patients may be required to pay an out-of-pocket fee at the time of service if they opt to supplement their mammogram with tomosynthesis.

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Posted in 3D Mammography, New Mammogram Technology, Screening Mammography, Tomosynthesis

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