Should women request latest 3D mammography?

3D mammography, or breast tomosynthesis, was approved by the U.S. Food and Drug Administration about five years ago.
 
Dr. Brett Parkinson at Intermountain Medical Center Breast Care Center recommends the latest techonolgy for breast screenings. Like traditional mammography, 3D mammography uses X-rays to produce images of breast tissue in order to detect lumps, tumors or other abnormalities. 3D mammography is capable of producing more detailed images of breast tissue.
 
3D captures multiple slices of the breast, all at different angles. The images are brought together to create crystal clear 3D reconstruction of the breast. The radiologist is then able to review reconstruction, one slide at a time, almost like turning pages in a book. This makes it easier for doctors to see if there’s anything to be concerned about.
 
3D Mammography Benefits to Patients:

  • Provides clearer images
  • Similar X-ray dose, compression and views compared with a traditional 3D mammogram
  • Detects more breast cancers
  • Reduces the chance of being called back for additional mammographic or ultrasound procedures

Traditional mammography produces just two images of each breast, a side-to-side view and a top-to-bottom view. 3D mammography produces many X-ray images of the breasts from multiple angles to create a digital 3-dimensional rendering of internal breast tissue. This allows radiologists to view the breast in 1-millimeter ‘slices’ rather than just the full thickness from the top and from the side.
 
3D mammography can be used for routine screening mammography and may be particularly effective for women with dense breast tissue or those at high risk for developing breast cancer.
 
Research suggests that radiologists are able to more accurately interpret results from 3D mammography in dense breast tissue, which can lead to fewer false-positive and false-negative readings. Women who have very dense breast may benefit or other imaging modalities that help cut through dense breast tissue.
 
The patient experience for a 3D screening mammogram is very similar to the traditional 2D mammogram. The technologist will position you, compress your breast, and take images from multiple angles. The X-ray dose, compression and views for a 3D mammogram are similar to the standard 2D.
 
During the procedure, the woman is positioned before a 3D mammography machine and her breasts are held in place by two compression plates. The pressure placed on the breasts by the compression plates can cause discomfort but only lasts for a few seconds.
 
When ready, the radiologic technologist will start the 3D mammography machine and a robotic arm will move in an arc over the woman’s breasts as multiple X-ray images are taken. The dose is similar to film mammography and is only slightly higher than in standard 2D digital mammography.
The scan itself takes less than two to three seconds per view. The entire procedure takes approximately 10 to 20 minutes.
 
A radiologist will interpret the results of 3D mammography, looking for signs of calcification or masses in the breast tissue.  A woman will be notified if her 3D mammography reveals that she has dense breasts or an abnormality in her breast tissue. If an abnormality is detected, a radiologist will likely recommend additional imaging procedures to help provide women with greater clarity and determine the cause of any true abnormality.
 
Utah has one of the worst mammography screening rates in the country, and one local physician says it's because most women don't see themselves getting breast cancer.
 
"Their most common reason is that they think they're not at risk," said  Brett Parkinson, MD, imaging director of the Breast Care Center at Intermountain Medical Center in Murray.
 
Not all cancers are found in women with a family history of breast cancer, he said.
 
"Over 75 percent of the breast cancers we diagnose at the Intermountain Medical Center are in women that have no previous family history or other risk factors," he said. "So basically all women are at risk … so they should get their mammograms."
 
Screening rates, he said, "are abysmally low" in Utah, with around 67 percent of women having had a mammogram for breast cancer screening in the past two years.
 
Breast cancer is the most deadly type of cancer among women in the Beehive State, and it affects more than double the number of women than any other kind of cancer, including thyroid, colorectal and melanoma cancers, according to the U.S. Centers for Disease Control and Prevention.
Dr. Parkinson said breast cancer rates have remained pretty stable over the years, but early and regular screening would help find those cancers when they are at more treatable stages.
 
Women are encouraged, beginning at age 40, to be screened with mammography for breast cancer, according to recommendations from the American Cancer Society and other health care organizations. Screening is recommended to continue annually.

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