Tomosynthesis / 3D Mammography
What is breast Tomosynthesis or a 3D Mammography?
Breast tomosynthesis uses high-powered computing to convert digital breast images into a stack of very thin layers or “slices,” building what is essentially a “3-dimensional mammogram.”
During the tomosynthesis part of the exam, the X-ray arm sweeps in a slight arc over the breast, taking multiple breast images in just seconds. A computer then produces a 3D image of your breast tissue in one millimeter layers.
Now the radiologist can see breast tissue detail in a way never before possible. Instead of viewing all the complexities of your breast tissue in a flat image, the doctor can examine the tissue one millimeter at a time. Fine details are more clearly visible, no longer hidden by the tissue above and below.
In the screening 2D mammogram (left image), there is a possible lesion in the central breast, but its margins are difficult to assess. Using tomosynthesis this can be clearly seen to be a spiculated mass, and almost certainly a malignancy.
An additional screening tool
For decades, doctors have been searching for a technology to help them find very small cancers while at the same time ruling out “false positives” and reducing the number of women who are called back for a diagnostic mammogram.
Scientists have developed a new technology called breast tomosynthesis, which has been shown in clinical studies to be superior to digital mammography. (1,2)
Breast tomosynthesis allows doctors to examine breast tissue one layer at a time. This exciting new technology has been recently FDA approved and is now available.
Breast tomosynthesis is a new technology in the fight against breast cancer. Breast tomosynthesis may be used in conjunction with traditional digital mammography as part of your annual screening mammogram to capture more breast images. Very low X-ray energy is used during the screening examination, so your radiation exposure is safely below the American College of Radiology (ACR) guidelines. Using breast tomosynthesis and digital mammography together for screening has been proven to reduce “call-backs.” (1,2)
What to expect during your exam
A tomosynthesis exam is very similar to a traditional mammogram. Just as with a digital mammogram, the technologist will position you, compress your breast under a paddle, and take images from different angles. A breast tomosynthesis exam may be used as a screening or diagnostic tool in conjunction with a traditional digital mammogram.
During the tomosynthesis portion of the exam, your breast will be under compression while the X-ray arm of the mammography machine makes a quick arc over the breast, taking a series of breast images at a number of angles. This will only take a few seconds, and all of the images are then reviewed by the technologist at her computer workstation to ensure that the images are of high quality.
The whole procedure time should be approximately the same as that of a digital mammogram. The technologist sends your breast images electronically to the radiologist, who studies them and reports results to either your physician or directly to you.
In the 2D image on the left, there is a potential lesion in the subareolar region of the breast. In the tomosynthesis images on the right, it is easy to see that there is no lesion present. One can pick out individual structures on the separate slices, which summate to form the potential lesion seen on the two-dimensional projection image.
How to prepare for your 3D mammogram
- Dress in a comfortable two-piece outfit
- Avoid wearing deodorant, powders, or creams
- Bring original films or CDs of any previous mammograms not performed at our facilities
- Bring your referral form from your doctor, your insurance card, and a picture ID
- Call 24 hours in advance if you must cancel your appointment
Is this technology covered by my insurance?
The FDA approved 3D mammography in February 2011. XRANM was the first in New Mexico to offer this technology and is offering this service in Albuquerque, Santa Fe and now Alamogordo. Because this technology is so new, some of the payers have not yet elected to cover this service and therefore insurance reimbursement rates are not currently available. However, the following insurances have elected to cover Tomosynthesis as a preventive service for their members: Blue Cross and Blue Shield (BCBS), Medicare, New Mexico Health Connections, New Mexico Medicaid, Centennial Plans and Presbyterian. There are changes taking place and other insurances will soon follow suit and will also cover this service. If you have any question regarding coverage, please call our office for assistance. For those insurances that are not currently being covered, we are offering this technology to patients as a voluntary addition to their traditional 2D mammogram at a self pay cost of $60 plus tax. This fee helps offset the cost of offering this new technology and includes the radiologist interpretation of the additional 3D imaging.
When do i get my mammography results?
Your exam will be interpreted by a Board-Certified Radiologist who specializes in Breast Imaging. You will receive a written letter in clear lay language within two to five working days.
2. The Hologic Selenia Dimensions clinical studies presented to the FDA as part of Hologic’s PMA submission that compared Hologic’s Selenia Dimensions combo-mode to Hologic 2D FFDM
XRANM was the first in New Mexico to incorporate the 3D mammogram technology known as tomosynthesis. We concluded that radiologists reading digital mammography(2D) plus breast tomosynthesis (3D) as compared to 2D mammography alone demonstrated superior clinical performance in specificity, the confidence to rule out breast cancer without recalling the patient for further study, and improved sensitivity, the proportion of mammograms with cancer which were correctly diagnosed. “We absolutely had the opportunity to find cancers earlier than we would have without tomosynthesis, as well as finding more extensive disease than was initially expected, ” says Dr Michael Linver. Mammography has played a significant role in women’s health, reducing the mortality rate from breast cancer by as much as 50 percent. With traditional mammograms, overlapping tissue can obscure abnormalities or make normal tissue appear suspicious. As a result, as many as 20 percent of breast cancers are missed on a mammogram, while approximately 10 percent of women are recalled for additional exams. By removing the confusion of superimposed tissue, tomosynthesis affects the two primary goals of mammography: finding cancers as soon as possible and reducing unnecessary callbacks.