Frequently Asked Questions About Digital Breast Tomosynthesis (3D Mammograms)

Penn researchers participated in the recently published study entitled: "Breast Cancer Screening Using Tomosynthesis in Combination with Digital Mammography," which reviewed almost half a million mammography exams. The study, published in the June 25, 2014 issue of the Journal of the American Medical Association (JAMA), found that tomosynthesis imaging, or 3D mammography, finds significantly more invasive or lethal cancers than a traditional, 2D mammogram.

3D mammography also reduces the number of women called back for unnecessary screenings; thereby reducing anxiety and health care costs.

Specific improvements with 3D mammography screening in the research found:

  • A 41% increase in the detection of invasive breast cancers
  • A 29% increase in the detection of all breast cancers
  • A 15% decrease in women recalled for additional imaging

Emily Conant, MD, senior author of the study

Digital Breast Tomosynthesis FAQs

What is digital breast tomosynthesis?

Digital breast tomosynthesis, or 3D mammography, is a technique using X-rays to produce a three dimensional picture of the breast. The result or output is a series of image "slices" through the breast that can be viewed as individual pictures. This often clarifies whether a finding is a true abnormality or an overlap of normal structures, and can result in the visualization of abnormalities that would be hard or impossible to see, otherwise. Standard, or 2D mammograms, consist of one picture of the breast in each position, as opposed to many slices. Overlapping breast tissue can make the 2D images difficult to interpret.

How are the 3D images obtained?

The 2D and 3D images for each view of the breast are obtained during a single breast compression. To obtain the 3D images, the X-ray beam swings in an arc, usually after the standard 2D views are obtained. Or, with the newest technology, the 2D images can be reconstructed from the tomosynthesis 3D images, decreasing the required dose. Compression will last for just a few seconds longer than for a standard mammogram without tomosynthesis, but most patients will likely not notice a difference.

Who should get breast tomosynthesis?

Everyone who is a candidate for 2D mammography is also a candidate for tomosynthesis. Patients with dense breast tissue may benefit more from the added modality than those with more fatty breast tissue, but even fatty breasts are better evaluated with tomosynthesis.

What about radiation exposure?

With studies where 2D images are reconstructed from the tomosynthesis images, the dose from the whole (2D and 3D) study is exactly the same as from a 2D-only study. Even for studies where the 2D and 3D images are both obtained, the total dose is still below the limit under the Mammography Quality Standards Act (MQSA) set forth by the FDA.

How do I get a 3D mammogram?

The referring clinician can order it, or the patient can request it at the time of the study.

Will patients be charged?

There is no additional charge to the patient.

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