While digital mammography is still one of the most advanced technologies available today, it is only a 2-dimensional picture of the breast. The breast is a 3-dimensional object composed of different structures, such as blood vessels, milk ducts, fat, and ligaments. All of these structures, which are located at different depths within the breast, can overlap and cause confusion when viewed as a 2-dimensional, flat image.
This confusion of overlapping tissue is a leading reason why small breast cancers may be missed and normal tissue may appear abnormal, leading to unnecessary call backs. In these cases, 3D mammography can offer a clearer look at the tissue with the same low dose of radiation as a 2D mammogram.
Screening 3D mammography is particularly useful for women with dense breasts (PDF). By law as of October 1, 2013, all Maryland mammography providers must notify patients who have dense breasts using the following language:
"You should know that dense breast tissue is a common finding and is not abnormal, with about half of women having dense or highly dense breasts. However, dense breast tissue can make it harder to find cancer on a mammogram and may also be associated with an increased risk of cancer. This information about the result of your mammogram is given to you to raise your awareness and to inform your conversations with your physician. Together, you can decide which screening options are right for you based on your mammogram results, individual risk factors, or physical examination. A report of your results was sent to your physician."
If you receive this notification (or have already been told you have dense breasts) you may want to discuss 3D mammography with your physician. 3D mammography uses high-powered computing to convert digital breast images into a stack of very thin layers or “slices”– building what is essentially a “3-dimensional mammogram”. A good analogy for 3D mammography is thinking of the pages in a book. If you look down at the cover you cannot see all of the pages – but when you open it up, you can go through the entire book page-by-page to see everything between the covers. 3D mammography is designed with the same concept in mind.
There is no additional compression required with 3D mammography, and it only takes a few seconds longer for each view. The technologist will view the images at the computer workstation to ensure adequate images are available for review by a radiologist, who studies them and reports results directly to you and to your physician.
Now that 3D mammography is available at our facility, you may have some questions. We’ve prepared this short Q&A to address concerns you may have.
What is a 3D mammography breast exam? 3D mammography is a revolutionary new screening and diagnostic tool designed for early breast cancer detection that can be done in conjunction with a traditional 2D digital mammogram. During the 3D part of the exam, the X-ray arm sweeps in a slight arc over your breast, taking multiple breast images. Then, a computer produces a 3D image of your breast tissue in one millimeter slices, providing greater visibility for the radiologist to see breast detail in a way never before possible. They can scroll through images of your entire breast like pages of a book.The additional 3D images make it possible for a radiologist to gain a better understanding of your breast tissue during screening1 and the confidence to reduce the need for follow-up imaging.2
Why is there a need for tomosynthesis breast exams? What are the benefits? With conventional digital mammography, the radiologist is viewing all the complexities of your breast tissue in one flat image. Sometimes breast tissue can overlap, giving the illusion of normal breast tissue looking like an abnormal area. By looking at the breast tissue in one millimeter slices, the radiologist can provide a more confident assessment.1 In this way, 3D mammography finds cancers missed with conventional 2D mammography.3 It also means there is less chance your doctor will call you back later for a “second look,” because now he or she can see breast tissue more clearly.
What is the difference between a screening and diagnostic mammogram? A screening mammogram is routinely ordered annually for women with no current breast issues. A diagnostic mammogram is for women and men to evaluate specific breast findings including lumps, pain, discharge, skin changes, or potential abnormalities noted on a Screening Mammogram. No matter what type of mammogram you have, we do our best to provide you with results on the same day.
What should I expect during the 3D mammography exam? 3D mammography complements standard 2D mammography and is performed at the same time with the same system. There is no additional compression required, and it only takes a few seconds longer for each view. You can see the machine in action in the second video above.
Who can have a 3D mammography exam? It is approved for all women who would be undergoing a standard mammogram, in both the screening and diagnostic settings.1
What costs are associated with getting a 3D mammography exam? At this time, insurance companies do not cover the cost of this procedure. Patients receiving a 3D mammogram are responsible for paying an additional fee. Ask your mammogram technologist for details.
Please call 240-566-3400 to schedule your annual screening mammogram appointment.
1Bernardi D, Ciatto S, Pellegrini M, et. al. Prospective study of breast tomosynthesis as a triage to assessment in screening. Breast Cancer Res Treat. 2012 Jan 22 [Epub ahead of print].
2The Hologic Selenia Dimensions clinical studies presented to the FDA as part of Hologic’s PMA submission that compared Hologic’s Selenia Dimensions combo-mode to Hologic 2D FFDM.
3Skaane P, Gullien R, Eben EB, et. al. Reading time of FFDM and tomosynthesis in a population-based screening Program. Radiological Society of North America annual meeting. Chicago, Il, 2011