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What is 3D or Tomosynthesis?
Digital Breast Tomosynthesis (also known as 3D mammography) was approved by the FDA in February 2011. It is a modification of the current 2D (digital) mammography which produces a 3D image of the breast.
Tomosynthesis creates multiple images or “slices” that step through the breast tissue. This allows the radiologist to see greater detail and helps reduce the impact of overlapping breast tissue. The process is performed at the same time as a normal mammogram, on the same scanner, with no noticeable differences in the experience or time expended for the patient.
What are the known benefits?
Reduced Callbacks: Tomosynthesis allows radiologists to look at different layers of the breast tissue, helping to distinguish normal breast tissue from abnormal breast tissue. Information from these additional images provided on the screening examination is believed to lead to fewer callbacks and, therefore, less anxiety for women.
Better Visualization: Radiologists can better determine the size, shape and location of an abnormality with tomosynthesis.
Improved Sensitivity: By minimizing the impact of overlapping breast tissue, tomosynthesis may improve breast cancer screening and early detection.
Who should consider 3-D Mammography/Tomosynthesis?
All women may benefit from tomosynthesis; however, the benefit is greatest in women with dense breast tissue, because dense tissue can mask cancers and/or lead to false positives.
How do you know if you have dense breasts?
Density refers to breasts the amount of glandular and connective tissue as compared to fatty tissue—not breast firmness—so a mammogram is the only way to determine breast density. You can either:
Speak with your physician. If you have had a prior mammogram, your primary care provider will have a report on record that would indicate your breast density, or
Speak with your mammography provider. If you have had a prior mammogram, your mammography provider will have a report on record that would indicate your breast density.
How is 3-D Mammography/Tomosynthesis different from 2-D mammography?
From a patient’s point of view: A 3D mammogram exam is very similar to a 2D mammogram—both are performed together on the same mammography unit. Just as with a digital mammogram, the technologist will position you, compress your breast under a paddle, and take images from different angles. During the 3D portion of the exam, the x-ray arm of the machine makes a quick arc over the breast, taking a series of breast images at a number of angles. The entire procedure should take approximately the same amount of time as a 2D mammogram.
From a technical point of view: The technologist sends your breast images electronically to the radiologist, who will examine breast tissue one layer at a time instead of viewing all the complexities of your breast tissue in a flat image. Fine details can be more clearly visible, less likely to be hidden by the tissue above and below.
Is 3-D Mammography/Tomosynthesis better?
All women may benefit from tomosynthesis; however, the benefit is greatest in women with dense breast tissue, because dense tissue can mask cancers and/or lead to false positives.
3D mammo is considered best practice clinically and provides higher cancer detection rate and has been proven to reduce the number of call-back exams.
Is there more radiation?
The radiation dose is approximately the same for tomosynthesis as it is for 2D mammography. 3D mammography reduces unnecessary call backs by up to 15- 40% and is much more accurate in early detection of breast cancer.
Does utilizing 3-D Mammography/Tomosynthesis mean I won’t be called back for additional views?
3D mammography can help radiologists rule out abnormalities that may have looked suspicious in a 2D mammogram, so the likelihood you’ll be called back may be less. However, there is still a chance that some patients will require additional mammographic views and/or ultrasound.
Is 3-D Mammography/Tomosynthesis covered by insurance?
For diagnostic 3D mammography, please check with your insurance as insurance plans differ.
What is the cost?
There may be a cost for diagnostic 3D imaging, please check with your insurance as insurance plans differ.
Can I add on the 3-D imaging after my 2-D mammography is complete?
The 3D images must be acquired at the same time as the 2D images.
Do I need a doctor’s referral?
If you are age 40 or older with no new breast concerns (lump, bump, etc ), you can schedule a mammogram on your own, anytime. While a referral is not required, please talk to your physician or mammography provider if you’d like to add it to your mammogram.