Tomosynthesis Coming to WDI but it is NOT a Substitute for Ultrasound

Low Dose Tomosynthesis is coming to Women's Digital Imaging this fall. Many of you have been asking me about this technology, so I want to explain what it is - and what it is not. Tomosynthesis is also called three dimensional mammography. The x-ray arm moves in an arc over the breast, providing images that are shown as a stack of very thin layers, or slices, unlike a two dimensional picture. Tomosynthesis has been shown to be an improvement over two dimensional mammograms in revealing tumors in dense breasts, but it still has the flaw of mammography in dense tissue: tissue is white and tumors are white so tumors can still be obscured. Tomosynthesis DOES NOT take the place of Ultrasound, and I will still be recommending Ultrasound for selected patients with dense tissue. On Ultrasound, tumors are gray and can be more easily seen. Tomosynthesis is anatomical; it shows the structure of breast tissue. I will also still be recommending MRI or BSGI, imaging modalities that are physiologic, meaning they show abnormal cell activity. Mammography has been very successful in finding tumors in women without dense tissue and has contributed to lowering the mortality rate for breast cancer. Even in women with dense tissue, mammography can show calcifications and other conditions that do not show up on ultrasound. Those of you who know me have long heard me say that breast cancer is a puzzle and we need different modalities to put the pieces together. Mammography is tool number one. Tomosynthesis is improved mammography. But we still need the other imaging modalities in our breast cancer screening tool box. Women's Digital Imaging stays on the forefront of new technology to foster our goal of early detection. We look carefully at new technology and will not add it just to have a shiny new piece of equipment. I did not feel confident until now that Tomosynthesis belonged at Women's Digital Imaging. Now that the radiation level has come down, we welcome Tomosynthesis at our practice. Women's Digital Imaging emphasizes individualized risk screening. We look at your medical history and family history and recommend the type and frequency of breast cancer screening best suited to your profile. Bottom line: Mammography - 2D or 3D - is the first imaging modality we use to screen for breast cancer but it does not give the complete picture. Supplemental imaging is needed to find cancer in dense breast tissue. If it is time for your annual mammogram, this is your reminder to call us at 201/444-4484 and make an appointment. We look forward to seeing you.

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