Low-Dose Tomosynthesis, 3-D Mammography, is the newest breast cancer screening tool at Women’s Digital Imaging but supplemental imaging is still needed in dense breast tissue.

December 17, 2015

Women’s Digital Imaging is renovating; we’re adding more space and more technology.  While  painters, carpenters and electricians refurbish the office, we have started using  Hologic Low-Dose 3-D Mammography (Breast Tomosynthesis) with C-View 2-D Imaging to enhance breast cancer screening of  our patients. The C-View 2-D imaging software, which just became available this year, reduces the radiation level of Tomosynthesis to that of a standard mammogram

 

Tomosynthesis, like the additional space, will help us do our job better.  A study presented at the December 2014 annual meeting of the Radiologic Society of North America, found that adding Tomosynthesis to standard mammography increased the number of cancers detected and decreased the amount of false positives compared to mammography alone.

 

Tomosynthesis gives us better visualization of the breast tissue. In standard digital mammography, there is overlap of the normal breast tissue, making abnormalities harder to see.  With Tomosynthesis, the camera moves over the breast in an arc taking pictures in slices that can be viewed one millimeter at a time.  By scanning through the breast images slowly, tiny masses and areas of distortion can be seen that may not be visible when all the breast tissue is overlapped on one view.

 

The C-View 2-D imaging software converts the images from 3-D to the standard 2-D, which produces a composite picture of all the images together. Patients experience half the amount of radiation as well as half the time spent in compression compared to Tomosynthesis exams without C-View.  

 

However, we still need supplemental screening modalities to find cancer in dense breast tissue.  On 2-D and 3-D mammography tissue is white and tumors are white.  Cancers can be hidden that are visible with other modalities such as Ultrasound.

 

In this video, “The Benefits and Limitations of Tomosynthesis,”   I compare images for two women.  Tomosynthesis proved that a suspicious area on the first patient was benign, but it couldn’t see through the dense white tissue of the second patient, where a nodule was identified with Ultrasound.

 

 

Studies conducted by Dr. Jean Weigert in Connecticut have consistently found an additional 3 cancers per 1000 women screened with Ultrasound when added to mammography.  MRI and molecular imaging are also important screening tools because they show metabolic activity, how cells behave, not just the anatomic picture may still be needed in patients with dense breast tissue.  Each modality shows tissue differently.

 

Until the day when we can distinguish between breast cancers that do no harm and ones that will metastasize, we need to find all of them at the earliest stage possible.  Low-DoseTomosynthesis, 3-D mammography, is our newest tool.  But it takes all our technologies, working together, to find those small cancers.

 

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