Digital tomosynthesis, or 3D mammography, has emerged as an effective breast imaging tool. 3D mammography combines conventional 2-dimensional mammogram images with additional 3-dimensional views. This enables enhanced views of breast tissue and research suggests 3D mammography offers several benefits over conventional 2D mammography.
Improved Cancer Detection Rate & Reduced Recall Rate
Numerous studies have shown the benefit of 3D mammography over conventional 2D mammography. Both prospective and retrospective trials have shown a significant increase in cancer detection and a decrease in recall rate with 3D mammography.
One prospective randomized trial, published April 2013 in Radiology by Skaane et al.[1] compared 3D and 2D mammography in more than 12,000 patients. Researchers determined a 27 percent increase in cancer detection with 3D mammography. A study of more than 7,000 patients, published June 2013 in The Lancet Oncology,[2] showed an increase in cancer detection of 50 percent.
In addition to improving cancer detection rates, research shows 3D mammography leads to fewer recalls than conventional 2D mammography. Two separate studies with more than 13,000 patients each showed a 30 to 37 percent decrease in recall rates. These were published December 2013 in Radiology[3] and June 2013 in American Journal of Roentgenology.[4]
The largest study to compare 3D mammography and 2D mammography included more than 450,000 patients. Results were published June 2014 in JAMA by Friedewald et al.[5] Researchers determined that 3D mammography led to a 15 percent decrease in recall rate along with a 29 percent increase in cancer detection. More importantly, detection of invasive cancers improved by 41 percent. This shows cancers being detected by 3D mammography are clinically important cancers.
What 3D Mammography Means for Patients
Improved cancer detection and reduced recall rates associated with 3D mammography are obvious benefits to patients. 3D mammography could be especially beneficial in certain patients, such as those with dense breast tissue, family history and other risk factors.
Radiation doses from 3D mammography and 2D mammography are approximately the same. Exposure from combined 2D and 3D mammography exams, as well as 3D mammography exams alone, fall within FDA-approved limits. Thus, 3D mammography is deemed safe and does not pose a significant risk to women. Undergoing a 3D mammography exam is similar to receiving conventional 2D mammography. Cost of a 3D mammography exam is also comparable. Additionally, because of the reduced recall rate associated with 3D mammography, this is expected to have long-term cost-effectiveness.
If you have questions about 3D mammography, please contact us.
[1] Skaane et al. “Comparison of Digital Mammography Alone and Digital Mammography Plus Tomosynthesis in a Population-Based Screening Program.” Radiology. April 2013. http://pubs.rsna.org/doi/10.1148/radiol.12121373
[2] Ciatto et al. “Integration of 3D Digital Mammography with Tomosynthesis for Population Breast Cancer Screening (STROM): A Prospective Study.” The Lancet Oncology. June 2013. http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70134-7/
[3] Haas et al. “Comparison of Tomosynthesis Plus Digital Mammography and Digital Mammography Alone for Breast Cancer Screening.” Radiology. December 2013. http://pubs.rsna.org/doi/abs/10.1148/radiol.13130307
[4] Rose et al. “Implementation of Breast Tomosynthesis in a Routine Screening Practice: An Observational Study.” American Journal of Roentgenology. June 2013. http://www.ajronline.org/doi/abs/10.2214/AJR.12.9672
[5] Friedewald et al. “Breast Cancer Screening Using Tomosynthesis in Combination with Digital Mammography.” JAMA. June 2014. http://jama.jamanetwork.com/article.aspx?articleid=1883018
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