The perks of 3-D Mammography
In 2017, the Food and Drug Administration approved the use of three-dimensional mammography (tomosynthesis) for use in screening. Columbus Community Hospital (CCH) began offering this technology at that time and since then it has become more prevalent across the country. Here are some common questions (and answers) regarding tomosynthesis.What's the big deal?
While standard (two-dimensional) mammography takes a single image of a woman's breast, three-dimensional mammography acquires and reconstructs multiple images to create a multidimensional reconstruction of a woman's breast. This allows for more precise screening for cancer, particularly in women who have dense breasts. This improved technology should allow breast cancer to be caught at a smaller size.
Since the technology was instituted at CCH, we have encountered multiple cases of cancer which were seen on the tomosynthesis images that were not visible, even with the power of hindsight, on the standard mammographic images. This translates to better surgical outcomes and, ideally, better overall survival rates.Is the experience different than my regular mammograms?
In general, the experience is very similar. Preparation instructions, gowning and positioning of the breast are identical between standard and three-dimensional mammograms. It does take more time for the machine to acquire the tomosynthesis images and part of the machine moves while the breast is in compression, and for some women, this longer time spent in compression is noticeable.Is there any difference in cost?
When three-dimensional mammography was initially approved, some insurance companies did not cover the additional cost of this technology. (All insurance companies cover the cost of screening mammography.) However, within the last six to 12 months, our experience has been that all insurance companies cover this cost.You said three-dimensional mammography was particularly helpful in patients with dense breasts. How do I know if I have dense breasts?
In Nebraska, it is mandatory for women who have dense breasts to be notified of this finding on their mammography results letter. Dense breasts are a normal finding, present in about 40 percent of women, but they have been associated with both an increased risk of breast cancer and a decrease in sensitivity of mammography. This makes the use of tomosynthesis especially helpful in women who have dense breasts.How do I know if I should be screened?
Women have a 1 in 8 chance of developing breast cancer during their lifetime. As a result, the American Board of Radiology, Society of Breast Imaging and National Comprehensive Cancer Network recommend annual screening mammography for women once they reach 40. Alternative guidelines set forth by the United States Preventative Services Task Force and the American Cancer Society are slightly more complex and offer alternative recommendations for the age at which screening should begin and the interval at which screening should be performed.
Personal medical history and family history of breast cancer can also affect the age at which screening mammography should begin. If you have questions about your particular situation, your primary care provider can assist you in determining when/if a mammogram is appropriate.Dr. Matthew Pieper is a radiologist with North Central Radiology at Columbus Community Hospital.
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