More than Mammograms, including Tomosynthesis, Needed to Find Cancers in Dense Breast Tissue

December 17, 2015

Tomosynthesis (3-D mammography) is not a stand-alone solution to breast cancer screening in dense tissue.  3-D mammography still misses mammographically occult (you can't see them) cancers in dense tissue.  A new study published in Journal of the American Medical Association (JAMA) and reported in New York Times, says Tomosynthesis found 41% more cancers, or an additional 1.2 cancers per 1,000 women screened when Tomosynthesis was added to Digital Mammography. That's a good step forward. But not far enough. Ultrasound added to Digital Mammography found 3 - 4 additional cancers.  That's a 103-138% increase using the same mathematical formula.
 
Tomosynthesis is a prettier mammogram. I have been waiting for the level of radiation to come down and I expect to add LOW DOSE Tomosynthesis, probably this fall.  But Tomosynthesis, like two dimensional mammography, shows both tissue and tumors in white, so cancers can be obscured in dense (white) tissue; On Ultrasound, tumors are grey.
 
Bottom line:  Mammography - 2D or 3D - does not give the complete picture.  Supplemental imaging is needed to find cancer in dense breast tissue.

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