What to Know About 3D Mammograms

Breast Cancer Facts Doctors Might Not Tell You

Since your last mammogram, your doctor might have replaced conventional 2D images with 3D technology called breast tomosynthesis, or 3D mammogram. Though the new technology doesn’t do away with that infamous vice grip on the breast tissue, it makes improvements on the 2D images.

“The image is clearer and, in most cases, cancer is found at a much earlier stage,” says Anita Johnson, MD, director of Breast Surgical Oncology at Cancer Treatment Centers of America in Newnan, GA.

What’s the Difference?

2D mammograms take two X-ray images of your breast: one from top-to-bottom and the other from side-to-side. Because it’s a single image of the whole breast pressed flat, sometimes normal tissue can hide abnormalities.

In tomosynthesis, the X-ray tube makes an arc around the breast, creating several images along the way. A computer turns the set of images into a 3D image of the breast.

“3D shows the breast tissue in very thin ‘slices,’ so you can see through the entire breast much more easily,” Johnson says.

In a trial of 96,269 women, tomosynthesis detected more cancers than conventional mammogram, with fewer false positives and callbacks. Women between ages 40 and 49, especially those with dense breasts, saw the biggest difference.

What You Should Know

3D mammograms are becoming more common. If you’re not sure whether your doctor uses them, ask.

The Society of Breast Imaging says almost all women should switch. Ask your doctor what they recommend for you.

Keep in mind, you might have to travel for the technology. “Most breast facilities, especially in metropolitan areas, have 3D mammography, but in some rural areas, they may not,” Johnson says.

You might also have to pay. Not all health insurance companies cover the added cost of the more expensive images.

Finally, tomosynthesis usually incorporates 2D images, too. That means more radiation into your chest. If you’re concerned about radiation, ask the breast center whether their machines generate “synthetic” 2D images, which reduces radiation.

In the end, the best mammogram is one you are able to get at the recommended intervals and not put off.

4 Lessons

“Whether it’s a 2D or 3D image, the goal is to get your mammogram when it’s recommended,” says Johnson. Here’s what the American Cancer Society advises:

  • Talk to your doctor at age 40 about your individual risk and when to start screening.
  • Get yearly mammograms from at least age 45 to 54.
  • Continue with yearly screens or switch to every other year at age 55.
  • Schedule regular mammograms for as long as you are in good health.

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Anita Johnson, MD, Director, Breast Surgical Oncology, Cancer Treatment Centers of America, Newnan, GA.

Radiology Info: “Breast Tomosynthesis.”

JAMA Oncology: “Association of Digital Breast Tomosynthesis vs Digital Mammography With Cancer Detection and Recall Rates by Age and Breast Density.”

Society of Breast Imaging: “Should I get a tomosynthesis instead of just a mammogram?”

American Cancer Society: “American Cancer Society Releases New Breast Cancer Guideline.”

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