3-D Mammography Can Improve Detection and Callback Rates

Although narrow clinical studies have illustrated 3-D mammography’s superiority over traditional digital mammography alone in detection and false positive rates, these findings are bolstered by a recent study published in The Journal of the American Medical Association.  The new report cites data from thirteen breast centers, providing a much more diverse sample population than previous studies. According to the report,

“Addition of tomosynthesis to digital mammography was associated with a decrease in recall rate and an increase in cancer detection rate.”[1]

The researchers followed nearly 500,000 patients and found significant improvements in detection rates, especially for invasive cancers, and in recall rates. With the addition of breast tomosynthesis, cancer detection increased 29% over digital mammography alone, and detection of invasive cancers increased 41%.  At the same time, while 106 women per 1000 who underwent 2-D digital mammography alone were called back for further testing, only 89 of 1000 who received breast tomosynthesis were recalled.[2] Overall, 3-D mammography resulted in a 15% reduction in false positive results.[3]

What this means for mammography patients is that the use of 3-D imaging has the potential to reduce their chances of being called back for additional tests while increasing the likelihood that existing cancer, and especially invasive cancer, will be identified in screening.  Reducing callbacks and false positives translates into less money spent on unnecessary testing and less stress induced by misleading or inconclusive mammogram results.

Mammography and Breast Density

Because 3-D mammography allows the radiologist to examine breast tissue in much finer detail, it is an especially valuable tool for women with dense breasts. Dense breasts contain less fat and more fibrous and glandular tissue.  Tumors and dense breast tissue both appear white on a mammogram, making it difficult to identify cancer.  In fact, women with dense breasts are nearly twice as likely to receive a false positive result than a woman with fatty breasts.[4] At the same time, women with dense breasts can have a higher risk of developing breast cancer.[5] Breast tomosynthesis can help find cancer earlier in this population that has a greater need of advanced detection methods.

Getting a 3-D Mammogram

Although the Food and Drug Administration approved breast tomosynthesis in 2011, most insurers are still not covering the cost.  Iowa Radiology offers breast tomosynthesis to our mammography patients for an additional charge of $40.  The exam time is about the same as with digital mammography alone, as 3-D and 2-D images are obtained at the same time.  No additional compression or adjustment of the breast is necessary. If you would like to discuss adding breast tomosynthesis to your next screening mammogram, call and ask for a mammography technologist. We are happy to answer any questions you may have.

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