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How 3D Mammography Improves Breast Cancer Detection

March 30, 2017

About 1 in 8 American women will develop breast cancer in her lifetime, but one technology is improving breast cancer screening and helping us detect the disease earlier.

3D mammography is a screening and diagnostic tool for breast cancer. Digital breast tomosynthesis, or 3D mammography, involves capturing multiple angled projections of the breast using an x-ray tube that rotates in an arc over the compressed breast. This data is then converted by a computer into a stack of very thin images that can be viewed on a high resolution monitor. Unlike traditional two-dimensional mammograms, the technology behind 3D mammograms reduces the limitations of dense or overlapping normal breast tissue structures which can make interpretation more difficult.

Detecting breast cancer while the patient is asymptomatic is the goal of screening mammography. 3D mammography has been shown to increase cancer detection rate in women without any signs or symptoms of disease. It also helps us recognize benign tissue and thereby eliminate the need for additional testing in some but not all patients, which leads to fewer false positive screenings. In traditional 2D mammography, routinely two images are performed of each breast. The fundamental shortcoming of this approach is that no matter how much compression is used, the breast is a still a three-dimensional structure. By creating a stack of thin images through the entire breast, 3D mammography reduces the confusing effects of overlapping breast tissue, which can make cancers extremely difficult, if not impossible, to detect on a standard 2D mammogram.

3D mammography is applicable to patients regardless of breast density or the presence of implants. However, one Radiological Society of North America study indicated that the technology can make detecting breast cancer easier in women with dense breast.

3D Mammography at ORMC Ambulatory Care Center

To enhance our current services, the ORMC Ambulatory Care Center (ACC) recently began offering 3D mammography. These enhancements to ACC Women's Imaging were made possible, in part, by the generous support of the Orlando Health Foundation. For mammograms performed at ACC Women's Imaging, South Seminole, and our new Spring Lake outpatient facility, both 2D and 3D mammograms will be performed routinely (with limited exceptions) without the need for a separate order for the 3D portion of the exam. While in some circumstances only a 2D mammogram will be performed, right now a 3D mammogram always is performed in conjunction with a 2D mammogram. The 2D and the 3D images are acquired sequentially in the same breast compression. The exam takes a few minutes longer to complete, but the appointments remain the same length per patient. These benefits come at a cost of two to three times the radiation dose to the breast, since each view is done twice of each breast. However, the benefits of this technology far exceed the risks of a greater radiation dose. If patients aren’t comfortable with this, they can always request to opt out of 3D mammography.

ACC Women's Imaging also has recently installed a state-of-the- art prone biopsy table with the added capability of performing tomosynthesis (3D) guided breast biopsies. This allows us to perform a biopsy on both abnormalities seen on 2D standard images and in the more challenging circumstance of a finding only seen on the 3D images. It also provides a more comfortable patient experience than the add-on devices that attach to the mammogram unit and require the patient to sit in a chair facing the machine.

As a designated Center of Excellence in Breast Imaging by the American College of Radiology, our goal is to give patients the best possible care. Our entire breast care program, including breast imaging at ACC Women's Imaging on the ORMC campus, is accredited by the National Accreditation Program for Breast Centers (NAPBC), meaning we are held to the highest standards of care for patients with diseases of the breast. We try to provide the most efficient and contemporary breast care using scientific evidence about what works best for patients. Offering 3D mammography is just one of the ways we’re trying to achieve this goal. Ultimately, this technology will help us detect breast cancer earlier, and that in turn will allow us to save more lives. 

If you would like to schedule an appointment for a mammogram today, please visit the Orlando Health imaging page for more information.

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