The U.S. Preventive Services Task Force did not find enough evidence to include an opinion on breast tomosynthesis in its recent draft proposal for breast cancer screening, but those who use 3-D medical imaging have seen its benefits. When this form of mammography is combined with the original 2-D version, radiologists have more accurate pictures from which to determine women’s breast health.
The issue with 2-D imaging
The USPSTF recommends mammograms biannually for women aged 50 to 74. This type ofdiagnostic imaging remains the only screening exam proven to reduce mortality rates for breast cancer, according to the Seattle Cancer Care Alliance. However, the 2-D format has its limitations.
The original computed radiography equipment only takes two images of each breast – one top to bottom and the other side to side. This causes problems when it comes to viewing images on a picture archiving and communication system. These 2-D images can cause layers of breast tissue to appear to overlap, which can hide potentially cancerous spots or lead to overdiagnosis, Selenia Dimensions explained.
With 2-D mammography, there are also issues getting a clear diagnosis in women with dense breasts, which is why 19 states require physicians to inform their patients if women have the condition. Overlapping tissue in this situation can lead to even more confusing images for radiologists and further hide problematic masses.
New 3-D technology has its benefits
Many systems, such as breast ultrasounds, claimed to improve breast screenings, especially in women with dense breasts. However, ultrasounds can still lead to false positives. Breast tomosynthesis, on the other hand, works side-by-side with its 2-D counterpart and can be performed at the same time.
Tomosynthesis takes 11 pictures from various angles in less than 10 seconds. The files are then sent to the PACS and combined to create 3-D images. Radiologists can view the pictures in millimeter sections to gain fuller understandings.
From these pictures, doctors can detect smaller cancers sooner, determine size and location of masses more accurately, perform fewer unnecessary biopsies and testing, see clearer images of dense tissue, and identify multiple tumors, Massachusetts General Hospital, who pioneered this type of screening, explained. With a more accurate diagnosis, breast tomosynthesis has reduced recall rates by 40 percent and increased cancer detection by 25 percent, Selenia Dimensions reported.
Tomosynthesis is not widely used because not much research is available on the topic, but to those who utilize this diagnostic imaging exam, the benefits are endless.
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Ronny Bachrach
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