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What's the big deal about 3D mammography?


Originally published in Montana Woman Magazine, October 2018. 

Every month is a great month to talk about healthy living, but October is a particularly good month to focus on breast health. That’s why we’ve prepared a quick overview of 3D mammography and how this relatively new technology is making significantly positive impacts. And this is not just for women, but for families. After all, cancer affects us all when a loved one is diagnosed. Even if you don’t have breasts of your own, you likely know someone that does so be sure to remind them how important mammograms are.

What’s the difference between 2D and 3D mammography?

Prior to 2011, the conventional approach to breast cancer screening was 2D imaging for most of the patient population. Traditional, or two-dimensional, mammography compresses the breasts and uses low-dose x-rays to take four pictures: two pictures of each side. With 3D mammography, also called tomosynthesis or tomo for short, a low-dose x-ray sweeps over the breasts in a spherical manner and takes numerous pictures along the way. Then, a computer “stitches” the pictures into two 3D images of each breast for the radiologist to examine, looking for anything out of the ordinary. In simple terms, 3D imaging gives radiologists a better picture of the breast. Tomo can be used as a screening exam, a regular test looking for breast cancer before symptoms are present; or a diagnostic exam, a test for investigating something out of the ordinary.

Isn’t 3D technology a gimmick?

Everyone loves a good 3D movie including the goofy glasses and reach-out-and-touch-you effects. Fortunately, 3D mammography is based in reality and sound science. No paper glasses required either. Doctors have shifted from 2D to 3D for several reasons and even use both technologies in tandem at appropriate times. Tomo, or 3D mammography, was developed to better enhance the view of the breast. The better the view, the better the chance of detection — no gimmicks.

In fact, studies have revealed that 2D imaging reported more false positives in comparison with 3D imaging. A false positive is when a mammogram detects an anomaly that looks like a cancer, but turns out not to be cancer. Ultimately, a cancer-free screening is the upside of a false positive, but the downside often means follow-up tests, extra doctor visits and, possibly, an unnecessary biopsy. The roller coaster ride of a false positive can take a psychological, physical and economic toll on patients and 3D technology is simply better when it comes to avoiding false positives.

Also, 3D technology has been shown to detect as many as 50% more cancers as traditional 2D mammography. While 2D mammography is still the standard of care, medical research continues to support 3D mammography for improved cancer detection and fewer false positives.

Why do I need 3D technology? I don’t have any symptoms or breast cancer in my family.

Regardless of your family history or absence of symptoms, annual screening mammograms for women over the age of 40 are recommended and strongly encouraged. It’s true for most women: we don’t look forward to our annual mammograms. However, cancer is much scarier than a routine mammogram. Cancer treatment includes a lot of side effects and is hard on the body.

“I’m convinced that 3D technology saved my life,” says Leanne Roberts, a local cancer survivor.

Leanne utilized 3D mammography the first year it was available in Kalispell and a tiny lump the size of a lemon seed was detected during an annual screening. She goes on to explain that it likely would have been two years before traditional imaging caught the same lump. It was treated successfully due to early detection.

“A mammogram may be uncomfortable for 10 to 15 minutes, but the thought of several months of chemotherapy, radiation, surgery and other drugs seems more uncomfortable to me,” shares Leanne.

Early detection means more options. If women wait until they see symptoms, such as a lump or a discharge, cancer is likely to be more advanced. And treatment may require more aggressive approaches.

What are the benefits of 3D technology?

Tomo or 3D mammography has been shown to be beneficial in the following ways:

  • Detect abnormalities that may have been hidden in dense breast tissue or folds due to compression during a traditional mammography
  • Increase early detection of breast disease
  • Decrease false positives, reducing unnecessary biopsies or additional tests
  • Provide greater accuracy in determining the exact size, shape, and location of abnormalities

Women with dense breasts and those at high risk for breast cancer benefit most from tomo. Early detection is the best defense against breast cancer, and breast cancer screening is the best way to detect breast cancer at its earliest stages when it is most treatable. Tomo can improve early detection and detection in dense breasts.

Who looks at my images?

After your 3D mammogram, a specially-trained breast radiologist will review your images. Amanda Beer, MD, is a subspecialist breast radiologist physician at The Women’s Center who interprets breast imaging and she knows precisely what to look for. She is an expert in women’s imaging including digital mammography, digital breast tomosynthesis (3D mammography), contrast enhanced spectral mammography, breast ultrasound, molecular breast imaging and breast MRI.

“I consider it a privilege to be a part of women’s health in the Flathead Valley. Educating patients about risk reduction when it comes to breast cancer is an important role that I take seriously,” says Dr. Beer. “I beg my own mother to drive 90 minutes from home to get a 3D mammogram. It is important to know that even if a 3D mammogram is not available, any mammogram, every year, after the age of 40, has been proven to save lives.”

Is it expensive to get a mammogram?

No, in fact, you can likely get a mammogram at no cost. Most health insurance plans include annual preventive screenings in standard coverage, including yearly mammograms for women over the age of 40. That’s great news and a great reason to put your routine screening on the calendar every 365 days. If you don’t have insurance or need support to get an annual screening Montana Save a SisterTM may be able to help. For more information about Save a SisterTM and available financial assistance, call (877) 399-0384.

Where can I get a 3D mammogram?

Kalispell Regional Healthcare offers two facilities and two locations for scheduling your mammogram. First, contact your primary care or women’s health care provider and ask them for an imaging order. Then call the imaging location of your choice to schedule your mammogram.