3D mammography outperforms conventional mammography in cancer detection and recall rates.
Recent research published June 2014 in the Journal of the American Medical Association reflects the potential for 3D mammography (digital breast tomosynthesis) to improve breast cancer screening. This is the latest study to shine positive light on 3D mammography, or digital breast tomosynthesis, a relatively new technology that can create detailed, three-dimensional visual representations of breast tissue. Researchers determined that, combined with conventional mammography, 3D mammography was able to reduce recall rates and improve breast cancer detection.
Researchers led by Sarah M. Friedman, M.D., of Advocate Lutheran General Hospital in Park Ridge, Illinois, assessed data from 13 imaging centers using 3D mammography. A total of 454,850 examinations were included in the study: 281,187 exams using conventional digital mammography alone and 173,663 combining conventional digital mammography in combination with 3D mammography.
Study results show benefits of Digital Breast Tomosynthesis
Landmark study evaluating close to half a million mammography exams published in the Journal of the American Medical Association (JAMA). Graphic courtesy of Hologic.
Study results, published June 2014 in the Journal of the American Medical Association, indicated that combining 3D mammography and conventional digital mammography was associated with a decrease in recall rate, the number of patients asked to return for more testing after a screening mammogram, and an increase in cancer detection rate. “There was remarkably consistent improvement in measured screening outcomes when 3D mammography was implemented,” researchers wrote.
Mammography alone found 4.2 cancers per every 1,000 scans while 5.4 were found by the combined technologies. More notably, 3D mammography combined with conventional mammography detected 4.1 invasive cancers per 1,000 scans compared to 2.9 for conventional mammography alone.
Recall rates were also lower when 3D mammography was used compared to when conventional mammography was used alone. There were 91 patients asked to return for more testing per 1,000 women screened when the combined technologies were used compared to 107 callbacks among women screened with mammography alone. When called back, the combined technologies detected cancer in 6.4 percent of instances compared to 4.3 percent for mammography alone.
Combining 3D mammography with conventional mammography did result in more biopsies than mammography alone: 19.3 per 1,000 scans compared to 18.1, respectively. However, the combined technologies resulted in a higher rate of biopsies finding cancer, 29.2 percent, compared to mammography used alone, 24.2 percent.
“The association with fewer unnecessary tests and biopsies, with a simultaneous increase in cancer detection rates, would support the potential benefits of 3D mammography as a tool for screening,” researchers concluded.
“In the 2D image on the left, we are looking at a potential lesion in the subareolar region of the breast. In the 3D image on the right, we’re able to see that, in fact, there is no lesion present.” False positive case courtesy of Hologic.
Who can benefit from 3D mammography?
Breast cancer screening with 3D mammography is an option that may be appropriate for many women. In some instances, 3D mammography used in combination with conventional mammography can result in increased radiation exposure when compared to conventional mammography used alone, although the increased dose falls within FDA limits for mammography. Increased radiation exposure can also be eliminated with special software, such as the C-View technology used at Breastlink Laguna Hills, which allows the combination of 3D mammography images and conventional mammography images without additional radiation.
While 3D mammography is available for any woman pondering her breast cancer screening options, this technology may be especially helpful for certain populations at higher risk for developing breast cancer. For instance, women with family history of breast cancer or dense breast tissue, which can mask some cancers on conventional mammography and is a mild risk factor for developing breast cancer, may want to consider 3D mammography as an alternative to conventional mammography alone.
Women aged 40 and above should start the breast cancer screening discussion, if they have not already, with their physician. While we believe conventional screening mammography performed annually in women aged 40 and older is the most valuable tool in the fight against breast cancer, other screening options are available – and 3D mammography is proving to be capable of reducing recall rates and improving breast cancer detection.
To learn more about breast tomosynthesis at Breastlink, please visit our 3D mammography page.