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Meet The New Mammogram: A 3-D Medical Breakthrough

It feels like the mammograms you've had before, squished breasts and all. But a 3-D scan has the potential to transform mammography by identifying more cancers early and avoiding some of the false-positive scares of the typical 2-D version.

"Today, breast cancer screening centers are adopting this method even faster than the conversion from film to digital mammography that took place in the 2000s," says Liane Philpotts, a professor of radiology and biomedical imaging and chief of breast imaging at Yale School of Medicine. (Never had a mammogram before? Here are 9 things you can expect at your first mammogram.)

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Although 3-D mammography—or tomosynthesis, the technical name—received FDA approval back in 2011, many screening facilities have just recently installed their first machines. Today, about a third of all FDA-certified mammography facilities in the US have at least one 3-D mammography machine. "It's like once you have a smartphone, there's absolutely no going back," Philpotts says. "This is a smarter mammogram."

mammogram changes over years
A Visual History Of Breast Screening: Early mammograms were really just glorified chest x-rays (top left). We've come a long way since then.
Lawerence Bassett, MD

In 3-D mammography, a camera takes a series of x-rays as it moves over the breast, snapping pictures from different angles. "Standard 2-D mammograms produce a single image of overlapping breast tissue. But radiologists can view the images from a 3-D mammogram as if they were paging through a book," says Martin J. Yaffe, a senior scientist at Sunnybrook Health Sciences Centre in Toronto.

MORE:6 Answers To Your Most Common Mammogram Questions

The images are arranged to provide a three-dimensional view, giving doctors a more detailed picture that helps them better distinguish suspicious spots from normal overlap.

Depending on which model machine is used, the 3-D scan often takes just a few seconds longer than a 2-D mammogram and may compress the breast slightly less. "A woman hardly notices a difference between getting a 2-D and a 3-D mammogram," Philpotts says.

Bobbie Smith, a 72-year-old retired elementary school music teacher and choral director from Tallahassee, FL, credits the new technology with saving her life. In 2014, a 3-D mammogram helped doctors diagnose her inflammatory stage 3 breast cancer.

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"I had heard the 3-D mammogram might give the doctors more information," Smith says, so she specifically requested the 3-D scan after noticing what looked like new stretch marks on her breast, coupled with unusual neck pain. She'd been having regular mammograms since she turned 50, but this was her first in 3-D. "I didn't feel anything different," she says of the 3-D experience. "I just knew that the pictures were going to be different."

Smith required months of chemotherapy and radiation followed by surgery to remove the affected breast and 25 lymph nodes. While her doctors say a 2-D mammogram might also have detected the cancer, the 3-D mammogram enabled them to see that the cancer had advanced throughout Smith's breast, a discovery that helped get her scheduled for a biopsy and treatment quickly. "I encourage other women to start having 3-D mammograms," she says. "I hope this test will allow other people to be diagnosed and treated sooner."

The 3-D technology can be a boon for women without breast cancer, too. According to the American College of Radiology, for every 1,000 women screened by a 2-D mammogram, about 100 will be called back for further testing because something on the image looks suspicious. Of those 100 women, only five will be diagnosed with breast cancer. The high rate of false positives causes undue fear and anxiety and costs women time and money. Studies suggest that 3-D mammography results in fewer unnecessary callbacks.

What's missing from this promising picture is long-term data. The National Cancer Institute recently funded the largest study to date on the benefits of 3-D mammography. The Tomosynthesis Mammography Imaging Screening Trial, or TMIST, will compare the cancer-detecting accuracy of 3-D mammography with that of standard exams. Yaffe, one of the TMIST investigators, and his colleagues plan to study more than 160,000 women, starting this year.

MORE:Here's What Reduces Your Risk Of Dying From Breast Cancer Even More Than Annual Mammograms

Until that data comes in, health organizations that typically provide breast cancer screening guidelines for women, like the American Cancer Society, are reserving judgment before making recommendations. Yaffe is confident those recommendations will come soon, as he's optimistic his study will prove 3-D mammograms beneficial. "My opinion is that gradually tomosynthesis will replace 2-D mammography," he says.

Meanwhile, the technology continues to evolve. "It's a better mammogram today than it was 6 years ago," says Emily Conant, a professor and chief of the division of breast imaging at the Hospital of the University of Pennsylvania.





Video: GE 3D Mammography Patient Video

Meet The New Mammogram: A 3-D Medical Breakthrough
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Date: 10.12.2018, 00:32 / Views: 84284