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3D imaging aids in earlier detection of breast cancer while reducing false alarms
By Richard Budde Jr.

The latest 3D technology is no longer just for televisions and movie theaters. Tomosynthesis, commonly known as 3D mammography, is giving breast imaging specialists another tool in the early detection of breast cancer.

Tomosynthesis is similar to a routine mammogram, but instead of capturing two stationary images per breast, the 3D unit acquires multiple low dose images of each breast.
Using tomosynthesis, breast imaging experts can view complex, overlapping breast tissue one layer at a time, as opposed to the flat or two dimensional image created by traditional digital mammography.

For the patient, the experience of getting a mammogram with tomosynthesis is similar to that of a traditional digital mammogram. The length of the exam is about the same and the breast images are still transmitted electronically to the physician. The main difference is the X-ray arm of the mammography machine moves around the patient in a short arc while taking a group of low dose images in just a matter of seconds.

Moreover, tomosynthesis is especially useful for women with mild to extremely dense breast tissue. The additional slices or images provide a more thorough view of the breast tissue, enabling breast imaging specialists to see more clearly the previously obscure details on 2D mammography. Research has shown that tomosynthesis improves cancer detection in patients with dense breasts by up to 30 percent.

Breast density is measured based on the American College of Radiology's BI- RADS breast composition categories. There are four density types: "A" designates entirely fatty breast tissue and "D" indicates extremely dense breast tissue. It is generally agreed that approximately 90 percent of women fall into density categories B, C and D.

While tomosynthesis received FDA approval for use in the U.S. in 2011, it is now becoming more readily available, as more research findings are released supporting its benefits.
Studies have shown that tomosynthesis, in combination with traditional full field 2D digital mammography, can reduce false positive biopsy results by up to 15 percent as well as significantly increase cancer detection rates, including up to 40 percent more invasive cancers.
Research has also shown the more detailed imaging provided by tomosynthesis can reduce callbacks for additional testing by approximately 30 percent, thus eliminating anxiety and inconvenience for many patients.

Annual mammograms are recommended for women over 40 (or sooner for patients with a strong family history of breast cancer), regardless of the degree of breast tissue density. Regular monthly self exams and an annual clinical breast exam are also recommended. While 3D mammography is a significant emerging technology for breast imaging experts, full field digital mammography (2D) continues to be widely effective and remains the current standard of care.
By Dr. Richard Budde, Jr., is a breast imaging specialist with KentuckyOne Health Breast Care at Saint Joseph East.

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