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3D Mammography: Fighting Breast Cancer with New Tools

Posted on Oct 16, 2014 in Cancer

Harriet Borofsky, M.D., medical director of the Mills-Peninsula Women's Center, reviews mammograms using  3D mammography, also called tomosynthesis.

Harriet Borofsky, M.D., medical director of the Mills-Peninsula Women’s Center, reviews mammograms using 3D mammography technology, also called tomosynthesis.

Every year more than 200,000 American women are diagnosed with invasive breast cancer. Women whose cancer is detected early by mammogram are less likely to die of the disease. Studies indicate there are 30 to 40 percent fewer deaths among women screened with mammography. But traditional mammograms can’t detect all tumors, and some are hidden behind overlapping breast tissue. 3D mammography is changing that.

Taking a Closer Look

Tomosynthesis – also called 3D mammography – is similar to a traditional mammogram, except it moves in an arc over the breast, taking many low-dose X-rays from different angles to create a three-dimensional view of breast tissue. The tomographic (or cross-sectional) images are reconstructed in very thin layers that radiologists can examine, one layer at a time, like a CT scan.

“In all my years as a radiologist, this may be the most impactful advance in finding breast cancer early, when it’s more easily treated,” says Harriet Borofsky, M.D., medical director of the Mills-Peninsula Women’s Center.

The proof is already in. Nationally, a study of nearly 500,000 women found that 3D mammography detected 41 percent more breast cancers than traditional mammograms.

The 3D technology can also clearly reveal when dense, overlapping breast tissues are normal, sparing women unnecessary stress and follow-up tests. Since switching to this advanced technology at Mills-Peninsula, Dr. Borofsky says the number of women called back for more X-rays or ultrasounds has been reduced at the Women’s Center by 40 percent.

“It’s a better mammogram in so many ways,” Dr. Borofsky says. “It’s significantly improved our detection rate in just six months. And it’s reduced our call-back rate.”

Mammogram Controversies

The value of mammograms has been questioned over the past few years in some public health circles. One criticism: Mammograms miss too many tumors, especially in women with dense breast tissue. Another: Too many women who don’t have cancer are called back for unnecessary biopsies and X-rays because of unclear results.

3D mammograms improve breast cancer screening on both of these fronts: More cancers are detected, and there are fewer false positives. Will 3D mammograms change the national debate? Dr. Borofsky doubts that. “The whole controversy about screening mammograms has become political, influenced by the cost of screening and the benefits for subsets of women.”

It’s true, she says, that the majority of women who get screening mammograms don’t have breast cancer. But if you are a woman with a small tumor, mammograms can save your life.

“We already know that women who are screened for breast cancer have a lower death rate than women who are not screened. That’s a fact,” Dr. Borofsky says.

Nationally, the number of women who die from breast cancer has dropped by 34 percent since 1990, thanks to early detection and improved treatments, she says.

Improving Treatments

“Screening has altered the way we treat breast cancer,” Dr. Borofsky explains. “Two decades ago treatments were more aggressive, and most women got chemotherapy. Because of early detection, the majority of breast cancers found now are very early stage. This has led to advances in less invasive treatments.”