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FAQs About Mammograms, Including 2D and 3D Mammograms, ABUS and Fast Breast MRI


Since 1990, breast mammography has helped reduce breast cancer death rates in the U.S. by nearly 40 percent. If it’s your first time getting a mammogram or even if you’ve been getting one each year, new advances in diagnostic imaging may affect what you choose to get next.

In general, mammography devices are upright X-ray machines that take low-dose pictures of the breast to look for abnormal masses, distortion of architecture or calcifications.

It’s the type of software that radiologists use that differentiates between a 2-D and 3-D mammogram. For example, in a 3D mammogram, multiple images of the breast are taken and sent to a computer that produces a layered 3D image of the breast tissue. These images provide greater detail and allow the radiologist to see the breast layer by layer to find cancers earlier than ever before.

Here are some frequently asked questions about different types of mammograms and how women may benefit.

What is the difference between a regular mammogram (2D mammogram) and digital breast tomosynthesis (3D mammogram)?

The conventional or a 2D mammogram takes a single image of your breast with each exposure that is taken.

A single acquisition of a 3D mammogram allows for the generation of multiple images to create a three-dimensional view of the breast. A computer algorithm generates multiple “slices” to allow the radiologist to get a better view of your breast tissue. This decreases the overlap of normal tissue resulting in up to 40 percent improved cancer detection and has additional benefits, such as reduction in callback evaluations.

In what instances would you use 3D mammogram?

A 3D mammogram can be used for both screening and for diagnostic examinations. Since the acquisition for both the 2D and 3D mammogram is very similar, a patient would not notice the difference. The 3D mammogram image just takes a little bit longer to acquire.

At Penn Medicine, how quickly would you expect to receive your results?

If you have your screening mammogram performed at Penn Medicine, once the report has been signed off by the radiologist, you should be able to receive the results immediately in myPennMedicine, our patient portal. Other mammogram and imaging results will be delivered three days after your exam.

This is one of the benefits of having a myPennMedicine account. We also mail out the result letters to our patients.

Your doctor, who ordered the mammogram, will also get the results in his or her inbox. For your other Penn doctors, they may look at your mammogram results any time in the electronic medical records.

What is the difference between a conventional breast MRI study and a FAST Breast MRI?

There are many indications for the conventional breast MRI examination. Perhaps the most common indication is screening for breast cancer in women who have greater than 20 percent lifetime risk for breast cancer. Typically, the women who fall in this group are women who have very strong family history of breast cancer or possibly one of the genetic mutations that puts her at an increased risk far above the general population.

The FAST Breast MRI examination is a shortened version of a conventional breast MRI examination tailored for women who want supplemental screening, in addition to mammography, if they have dense breast tissue.

Although the FAST Breast MRI examination is an abbreviated form of the conventional MRI examination, scientific studies have shown that it is almost as good. In addition to having dense breast tissue, additional criteria for scheduling the Fast Breast MRI include:

  • Having a negative mammogram within the past 11 months
  • Not experiencing any breast related symptoms such as a breast lump or nipple discharge

Do you need a script for a FAST Breast MRI?

Yes, you will need to get a script from your health care provider for the examination. Your health care provider will also need to order the exam. The examination can be scheduled by calling the following locations:

  • Pennsylvania Hospital - 215-829-7530
  • Penn Medicine Cherry Hill - 856-433-2535
  • Penn Medicine Valley Forge - 610-576-7550
  • Perelman Center for Advanced Medicine - 215-662-6912

You can also complete our secure online form.

How much does the FAST Breast MRI cost?

The cost for Fast Breast MRI is $299. Your doctor will also need to place an order for the study, similar to any other radiology examination.

What is ABUS (Automated Breast Ultrasound) for supplemental screening for dense breasts?

Automated Whole Breast Ultrasound (ABUS) is a quick, safe, and non-invasive ultrasound examination. The study uses high-frequency ultrasound waves to produce sharp, three-dimensional images of the interior of the breast. In most cases, the scan produces more than 1200 images.

Unlike traditional mammography, ABUS technology is not affected by breast density. As a secondary screening examination, it is able to “see through” dense tissue.

The ABUS machine is small, consisting of a base unit with a monitor and an arm with the ultrasound transducer (which sends out sound waves and listens to the echoes). The transducer is padded and curved to fit comfortably on the breast.

I already get a mammogram every year. Why should I have ABUS performed?

Screening mammography, the standard for breast cancer detection, has known limitations in women with dense breast tissue, and women with dense breast tissue have a higher lifetime risk of developing breast cancer.

Clinical evidence demonstrates that supplementing mammography with ABUS for women with dense breast tissue can increase breast cancer detection. Undergoing automated breast ultrasound provides additional peace of mind.

Does health insurance cover whole breast ultrasound?

Many health care providers cover whole breast ultrasound, including automated whole breast ultrasound. The coverage varies depending upon state and upon the insurance policy.

The ABUS may be scheduled by calling the following locations:

  • Pennsylvania Hospital - 215-829-6686
  • Penn Medicine Cherry Hill - 856-433-2535

What is the breast density notification legislation and how does it pertain to me?

The Breast Density Notification Legislation is a law that requires women be informed about their mammographic breast density. There are four categories of breast density: fatty, scattered, heterogeneously, or extremely dense. Each mammogram report will indicate your breast density.

Pennsylvania and New Jersey are two of many states that have passed the Breast Density Notification Legislation requiring that women be notified of their breast density in their mammogram results letter.

Although the legislation does not suggest specific screening recommendations, women with dense breast tissue (heterogeneously or extremely dense breasts) are recommended to speak to their healthcare providers about whether a supplemental screening study may be appropriate for them. This is a personal decision as additional testing may result in detecting cancers that may not be visible on your mammogram, but the additional testing also may result in false positive results or the detection of noncancerous findings.

For the women who have dense breast tissue and desire supplemental screening, at Penn Medicine, we are offering the FAST Breast MRI and Automated Breast Ultrasound examinations.

Although Pennsylvania and New Jersey have passed the breast density legislation, insurance companies do not always cover supplemental screening for women with dense breast tissue. In New Jersey, whole breast ultrasound is covered by insurance companies.

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The Focus on Cancer blog discusses a variety of cancer-related topics, including treatment advances, research efforts and clinical trials, nutrition, support groups, survivorship and patient stories.

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