Breast Tomosynthesis: A 3D Mammogram

3D Mammography / Mammography

Breast cancer is the #2 cause of  cancer-related deathsin women. One out of nine women will be  diagnosed with  breast cancer in  her lifetime.Doctors and scientists agree that early detection is the best defense against breast cancer. If we find cancer in its earliest stages, the chances of surviving it are good. Until now, the best way to do that has been with digital mammography. Digital mammography uses a specially designed digital camera and a computer to produce an image that is displayed on a high-resolution computer monitor. While digital mammography is still one of the most advanced technologies available today, it is only a two-dimensional picture of the breast. Since the breast is composed of pockets of dense tissue surrounded by fat, when x-rayed, it creates an image that looks something like a smoky haze. The overlapping tissue in the image makes it difficult to see tiny “spots”, called microcalcifications, and other subtle signs of early cancer. In some cases, the radiologist may ask you to come back for a follow-up examination such as a diagnostic mammogram to rule out any suspicious areas.

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3D Mammography
Mammography

3D Mammography
Frequently Asked Questions

What is a 3D mammography breast exam?
Why is there a need for tomosynthesis breast exams? What are the benefits?
What is the difference between a screening and diagnostic mammogram?
What should I expect during the 3D mammography exam?
Is there more radiation dose?
Who can have a 3D mammography exam?
What DIA Offices offer 3D Mammography?

What is a 3D mammography breast exam?
3D mammography is a revolutionary new screening and diagnostic tool designed for early breast cancer detection that can be done in conjunction with a traditional 2D digital mammogram.
During the 3D part of the exam, the X-ray arm sweeps in a slight arc over your breast, taking multiple breast images. Then, a computer produces a 3D image of your breast tissue in one millimeter slices, providing greater visibility for the radiologist to see breast detail in a way never before possible. They can scroll through images of your entire breast like pages of a book.
The additional 3D images make it possible for a radiologist to gain a better understanding of your breast tissue during screening(1) and the confidence to reduce the need for follow-up imaging.(2)

2d vs. 3d
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Why is there a need for tomosynthesis breast exams? What are the benefits?
With conventional digital mammography, the radiologist is viewing all the complexities of your breast tissue in a one flat image. Sometimes breast tissue can overlap, giving the illusion of normal breast tissue looking like an abnormal area.
By looking at the breast tissue in one millimeter slices, the radiologist can provide a more confident assessment. In this way, 3D mammography finds cancers missed with conventional 2D mammography.3 It also means there is less chance your doctor will call you back later for a “second look,” because now they can see breast tissue more clearly.
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What is the difference between a screening and diagnostic mammogram?
A screening mammogram is your annual mammogram that is done every year. Sometimes the radiologist may ask you to come back for follow-up images which is called a diagnostic mammogram to rule out an unclear area in the breast or if there is a breast complaint that needs to be evaluated.
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What should I expect during the 3D mammography exam?
3D mammography complements standard 2D mammography and is performed at the same time with the same system. There is no additional compression required, and it only takes a few more seconds longer for each view.
2d vs. 3d
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Is there more radiation dose?
Very low X-ray energy is used during the exam, just about the same amount as a traditional mammogram done on film.
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Who can have a 3D mammography exam?
It is approved for all women who would be undergoing a standard mammogram, in both the screening and diagnostic settings.(1)
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What DIA Offices offer 3D Mammography?
3D Mammography is available at these DIA offices: Brandywine Imaging Center, Women’s Imaging Center, Pike Creek Imaging Center and Glasgow Imaging Center
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(1) Bernardi D, Ciatto S, Pellegrini M, et. al. Prospective study of breast tomosynthesis
as a triage to assessment in screening. Breast Cancer Res Treat. 2012 Jan 22 [Epub
ahead of print].
(2) The Hologic Selenia Dimensions clinical studies presented to the FDA as part of
Hologic’s PMA submission that compared Hologic’s Selenia Dimensions combomode
to Hologic 2D FFDM.

Mammography
Frequently Asked Questions

What is mammography?
Why is getting a mammogram important?
Who is at risk of developing breast cancer?
What are the signs of breast cancer?
Who should have a mammogram?
Do mammograms hurt?
Is there any preparation for a mammogram?
What should I expect during my mammogram?
What happens if the radiologist finds something on my mammogram?
Does insurance pay for mammograms?
Recently I read an article that said getting a mammogram is unnecessary and may even do more harm than good. Is this true?
Which Diagnostic Imaging Associates locations offers mammography?
 Click here to read an article on What All Women Should Know About Breast Health

What is mammography?
Mammography is a procedure that uses x-rays of the breast to detect cancer and other disease or abnormalities before they can be felt or seen.
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Why is getting a mammogram important?
Breast cancer is the #2 cause of cancer-related deaths in women. One out of nine women will be diagnosed with breast cancer in her lifetime. The risk of developing breast cancer increases as a woman ages. Women over age 50 make up three-fourths of the breast cancer cases diagnosed each year. Although family history of breast cancer increases a woman’s risk of developing the disease, over 80% of women diagnosed with breast cancer have no relatives who have suffered from the disease.

The rate of breast cancer in Delawareans especially alarming. According to statistics from the American Cancer Society, Delaware is #2 in the country for new cases of in situ (noninvasive) breast cancer, #6 for current cases of invasive breast cancer, and #2 for breast cancer deaths.

Knowing you are free of breast cancer from your annual mammogram is the best way to put yourself at ease. It is estimated that death from breast cancer could be reduced by 30% to 40% with the use of annual mammography and clinical breast examinations (CBE). This is because early detection increases the chance of successful treatment that saves the maximum amount of breast tissue and has fewer side effects. The five-year survival rate for women diagnosed with breast cancer in an early stage is 90%. However, if the cancer is allowed to spread throughout the breast, the five-year survival rate decreases to 75% and then drops to 20% when it spreads to other areas of the body.
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Who is at risk of developing breast cancer?
A woman is more likely to develop breast cancer if she has any of the following risk factors:

  • Increasing age (each 10-year increase in age is associated with an increased number of diagnosed breast cancers)
  • Family history of breast cancer
  • First pregnancy after age 30, or having no children
  • Previous diagnosis of cancer
  • Menarche (first period) before age 12
  • History of benign breast disease
  • Nipple discharge when not nursing

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What are the signs of breast cancer?
Even though early breast cancer usually does not cause pain or symptoms, typical signs include:

  • A lump or thickening in the breast or underarm area
  • Change in the shape or size of the breast
  • Discharge from the nipple
  • Change in the color or feel of the breast or nipple, especially dimples or puckering of the skin

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Who should have a mammogram?
The American Cancer Society (ACS) recommends a yearly mammography for women age 40 years or older. Mammography should be performed in conjunction with a monthly breast self-examination (BSE) and a yearly CBE.

For women aged 20 to 39 years, the ACS recommends that a BSE be performed every month and a CBE every three years. Women in this age group with a strong family history of breast cancer should consult their primary care physician to discuss the appropriateness of screening mammography before age 40.
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Do mammograms hurt?
Over its history, mammography has developed a false reputation for being painful. There is no argument that the procedure can sometimes be uncomfortable, but it should never be painful. One way to avoid discomfort during mammography is to schedule your appointment after your period.
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Is there any preparation for a mammogram?
The day of your mammogram, please do not wear deodorant, perfume, powder, or lotion on the breast or underarm area. To make your mammogram go as smoothly as possible, wear a 2-piece outfit so that you only have to remove your top when changing into the examination gown. If this is your first appointment at Diagnostic Imaging Associates, please inform scheduling where you have had your previous mammograms so that we are able to obtain them for comparison.
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What should I expect during my mammogram?
After you have changed into a waist-length examination gown, you will be led into the mammography suite. Your study will be performed by one of DIA’s registered radiologic technologists who will fully explain the procedure to you. At this time it is important to alert the technologist if you have breast implants.

The technologist will position one of your breasts on the bottom plate of the mammography machine. A second plate will be placed over the top of your breast. These two plates will slowly press down on your breast, spreading the tissue so that it is easier for the radiologist to see abnormalities. The compression of the breast can cause discomfort; however, most women report none. Two x-ray images will be taken of each breast—one from the side and one from above. The entire procedure will take approximately 15 to 20 minutes.

After the films from your mammogram have been processed, one of our radiologists will compare them to your previous mammogram and examine them for any abnormalities or tumors. If you choose to have the ImageChecker scan your mammogram, the images will be run through the computer and analyzed for any areas that may need a second look. The radiologist will then examine at any areas of concern marked by the ImageChecker.

After the radiologist has read your mammogram, the findings will be sent to you in a letter. The findings will also be sent to your referring physician.
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What happens if the radiologist finds something on my mammogram?
After your mammogram has been read by the radiologist, a letter will be sent to you that reports any findings. Based on the results of your mammogram, the letter will provide specific instructions on any further action that is required of you. For example, these instructions may suggest another mammogram in six months, additional imaging, or follow-up with your physician.
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Does insurance pay for mammograms?
The majority of health insurance plans do cover annual mammograms for women over 40. If you do not have insurance coverage, several organizations dedicated to breast cancer awareness are located in Delaware and may be able to help you obtain a free or low-cost mammogram. To find a list of these organizations, contact Delaware Health and Social Services at (302) 739-4651 or (800) 464-HELP.
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Recently I read an article that said getting a mammogram is unnecessary and may even do more harm than good. Is this true?
In the past two years the Journal of the National Cancer Institute and Lancet published controversial studies reporting that women in their 50s benefited no more from mammography than a clinical breast examination (CBE). Although some organizations feel that screening mammography for women aged 40 and older is unnecessary and may pose harm because it uses ionizing radiation, this opinion is not shared by respected members of the medical community. Immediately upon the publishing of these articles, the American Medical Association, the American College of Surgeons, the American Cancer Society, and the American Academy of Physicians released statements advising women to continue getting annual mammograms. Members of these organizations point out that this controversial view is based on only two articles that contradict over 30 years of clinical evidence showing that mammography can save lives.

The earlier breast cancer is detected, the better the prognosis is an undisputed fact. Currently, mammography is the gold standard for early detection of breast cancer because it is the most accurate screening tool available. It detects 85% of all breast cancers. Because mammography is not perfect at detecting all cancers, every woman should perform a monthly breast self-examination and have regular CBEs in addition to their annual mammogram.

As for the amount of radiation exposure during mammography, there is no evidence that the current dosage poses a risk to the patient. The level of radiation typically received from modern mammography systems is between 0.1 to 0.2 rad per x-ray. At this level of dosage, a woman who has an annual screening mammogram (two x-rays per breast) from age 40 to age 90 will receive a total of 10 to 20 rads per breast. To put this dose in perspective, a woman undergoing radiation therapy for breast cancer will be exposed to several thousand rads.
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Which Diagnostic Imaging Associates locations offer mammography?
Diagnostic Imaging Associates has four locations in Delaware offering mammography— Pike Creek, Brandywine, Glasgow, and Womens Imaging Center. To schedule an appointment for your annual mammogram, please call Central Scheduling at (302) 369-4342 and we will find a convenient time for you to come in to have your mammogram.
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