You thought that it was only blockbuster movies going 3D! Well, screening mammograms are now available in 3D. Instead of a traditional flat image, 3D mammography, otherwise known as tomosynthesis, provides multiple digital images of the breast in slices which are then reconstructed by a computer to generate a 3D image.
Until now, there has been little evidence that this new technology offers any advantage to regular film or 2D digital mammography.
We now have a study recently published in JAMA* that shows an increase in cancer detection rate, particularly for invasive breast cancers. Regular 2 D mammograms required 815 women to be screened to find 1 invasive breast cancer and 3D mammograms required 707 women to be screened. It also showed a decreased recall rate for additional images, 107 women versus 91.
The study was not done over a long enough period to determine if 3D mammograms actually improve outcomes for patients, i.e. less breast cancer deaths.
There are some downsides, chiefly a higher dose of radiation for women with large breasts and the possibility of over detection. When a screening test gets too good, it can pick up things that would never have actually become a problem. This can lead to unnecessary treatment and a whole lot of anxiety. Lastly, 3D mammography is more costly and some insurance companies are not covering it.
So who should get this new kind of screening? Most women will be fine with regular 2D, but for women who have dense breasts, a higher than average risk of breast cancer, or have had a lot of recalls in the past, 3D mammography may be better.
*JAMA,June 25, 2014, Vol 311, No. 24
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