3-D breast imaging could revolutionize cancer screening

besa

http://www.sciencedaily.com/releases/2014/06/140617164334.htm

"In community-based radiology practice, mammography screening with 3D digital breast tomosynthesis (DBT) yielded lower recall rates, an increased overall cancer detection rate, and an increased detection rate for invasive cancer compared with 2D digital mammography (DM).

In the largest report to date, researchers at Washington Radiology Associates, PC, with offices in Washington, DC; Virginia; and Maryland, conducted a study of more than 59,000 patients. The results were striking: an increase in the detection rate for cancer overall of 28.6% and a 43.8% increase in detecting invasive cancers in patients screened with 3D DBT versus 2D DM.

"We observed a significant increase in the detection rate for cancer overall and an even greater increase in the detection rate for invasive cancer," said Julianne Greenberg, corresponding author of the study. "Our results may be a bellwether for the impact of tomosynthesis on population-based breast cancer screening."

The study appears ahead of print online in the American Journal of Roentgenology.

Journal Reference:

1. Julianne S. Greenberg, Marcia C. Javitt, Jason Katzen, Sara Michael, Agnes E. Holland. Clinical Performance Metrics of 3D Digital Breast Tomosynthesis Compared With 2D Digital Mammography for Breast Cancer Screening in Community Practice. American Journal of Roentgenology, 2014; 1 DOI: 10.2214/AJR.14.12642 "

 

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Ariom

This is amazing stuff. 

These were introduced here in Australia, at some of the major BreastScreen facilities last year. I have a friend who is a Radiographer and she can't speak highly enough of this technology. I am booked for September, which will be my 2nd Mammo on remaining side, after my Mx in late 2012.

farmerlucy

Those are huge increases in detection! I am so glad to hear that. Thanks for posting besa!

tryn2staycalm

This is wonderful!  I was in a breast screening program yet still in one year I went from everything normal to stage 3 grade 3 IDC (now progressed to stage IV).  In cases like mine with very aggressive cancers it could make the difference of saving lives.

cp418

My question/concern is how much more radiation exposure is there between these two technologies?  Especially if given on a yearly basis.  We already know that CT scans have approximately 40x more radiation exposure to a single X-ray and should only be used when necessary.  So is the newer technology safer?  Plus I wonder would it be another option for those with dense breast issues who are commonly missed on mammograms.

besa

http://www.washingtonradiology.com/bca/

CP418 - I did not have a chance to look this up in the peer reviewed literature but according to the Washington Radiology web site the radiation dose is roughly equivalent to the exposure in film/screen mammography.  

Ariom

I was told it adds about 8 additional seconds to the normal Mammo. Not sure if radiation is higher.

april485

I have had two 3-D mammos and the radiologist told me the increase in radiation is minimal. As for time, it is only a few minutes more and a few more views. Worth it!

cp418

See when I come across these articles - I don't know who to believe......

http://articles.mercola.com/sites/articles/archive/2013/08/27/3d-mammogram-risks.aspx

http://www.tomosynthesis.org/

 

 

Niloc

You need to be aware of the article sources. The first one is from a self labelled "Natural Health Website", whereas the second gives no dosage levels. 

Consider also that a standard mammogram sometimes needs to be redone, sometimes from an altered direction to clarify a detail, thereby doubling the exposure. The new digital 2D scans have greater definition than the previous analogue scans and can be digitally stored to compare with the next scan easier too.

cp418

Yes - I would like to know specific details / information about this new technology before I would use it.  I went for my yearly mammogram in April and the tech walked me into the room with this scanner.  She said it was new and there was more radiation exposure.  No specific details and I passed on it.  I was simply taken to the next room for digital mammogram.  Also, my GP allows me to schedule a Sonocine US at my cost during the same visit.   Just because the FDA approved it - doesn't mean a whole lot to me.......

 

This article mentions it is similar to a CT scan.  So my question/concern is for yearly exposure........

http://www.nbcnews.com/health/womens-health/breast-cancer-breakthrough-3d-mammograms-offer-sharper-results-n139611

http://www.diagnosticimaging.com/mammography/digital-breast-tomosynthesis-doses-comparable-mammography

http://www.womensdiag.com/services/mammography/tomosynthesis.html#d

besa

http://jama.jamanetwork.com/article.aspx?articleid...

http://www.washingtonpost.com/national/health-scie...

Here is the link to the  Journal of the American Medical Association article (June 25, 2014, vol 311, #34, Friedewall, et al.) listed in CP418's above link (the NBC article) - which also just came out. 

When researching a radiation exposure in tomosynthesis - there are newer lower radiation tomosynthesis systems so we need to pay attention to what system is being used in a specific study.  

(I have had 3D mammos for the last couple of years.  I have been told I am a very "difficult read" and  when using a 2D system multiple views are always necessary so in my case I am not sure if there is much difference in radiation exposure.)