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Traditionally, 2D or digital mammograms have been the best way for women to spot breast cancer early, when it’s most treatable. But they have limitations.
A potential trouble spot could appear as just that — a spot. The odds are that it’s not a tumor, but it could be.
“On a 2D mammogram, you may see a zone of density and you can’t be sure what it is,” says AdventHealth Radiologist Leena Kamat, MD.
So the patient has to return to the imaging center to get more images taken or undergo a biopsy. In the medical world, this is called a “callback,” and for patients it’s a hassle and likely a significant source of worry.
But if the radiologist could have looked around the spot — beneath and above it — she could have seen whether it’s a harmless clump of fat or a dangerous tumor. Now, she can.
It’s called 3D mammography, or breast tomosynthesis (commonly just “tomo”).
“Tomo allows you to scroll through multiple levels and see if it’s just regular tissue or a potential tumor,” Dr. Kamat says.
It also allows radiologists to find small tumors that could be hiding in denser areas of the breast. These areas appear as white spots on mammograms and can sometimes block our view of tumors, which can be disguised as white spots.
“Tomo gives you that ability to look through the tissue and be able to catch something that would’ve been obscured,” Dr. Kamat said.
3D mammography is especially important for women with dense breasts.
How 3D Mammography Helps Women With Dense Breasts
A woman’s breasts are composed of several kinds of tissues, including fat, milk ducts and supportive tissues. Different women have different amounts of each, and they change over time.
A woman who has more dense tissue than fatty tissue is said to have “dense breasts.”
Having dense breasts is common — about four in 10 women have them. Younger women are more likely to have dense breasts. It’s perfectly normal, not a disease, but having dense breasts does put a woman at higher risk of cancer.
(To learn more about dense breasts and what they mean for you, check out our post.)
“Women with dense breasts get the greatest benefit from 3D mammography,” Dr. Kamat says.
Traditional, 2D mammography has limitations for women with dense breasts because dense tissue appears as white on its images. In 3D mammography, the radiologist can get a better idea of what these spots truly are by looking above and below them.
If you’re not sure whether you have dense breasts, take a look at your mammogram results. The state of Florida requires patients to be notified about what dense breasts mean for them.
Why the Best Mammography Matters
For a woman, finding a small tumor in a regular screening mammogram is often a moment of profound fear. But seen at a further distance, it’s a victory. A small tumor that hasn’t spread is more than treatable. Usually, it’s curable.
Giving women these victories were a big part of why Dr. Kamat decided to specialize in breast cancer radiology.
“I think there’s something incredibly rewarding in that,” she said. Dr. Kamat routinely used 3D mammograms during her one-year breast imaging fellowship in 2017.
“Finding a tumor when it’s small is the goal of screening and it affords a person the best chances,” Dr. Kamat says. “I think 3D mammography is the way of the future.”
Evidence continues to show 3D mammograms are better at finding cancer. An October 2018 study that tracked 15,000 women over five years found 3D mammography detected 30 percent more cancers than traditional mammography.
Our adoption of the most effective technology is one reason women trust us with their health. Part of that peace of mind comes from getting the right answer the first time and avoiding stressful follow-up appointments.
To learn more about getting your mammogram or to schedule an appointment, click here.