The two-dimensional mammogram is still the “gold standard” in breast cancer detection but the head of imaging at Memorial Hermann Katy Hospital doubts that will be the case in a few years.
“I think 2-D is going to go away,” said Robin Judman, also the chief of imaging at the Memorial City branch’s MD Anderson Cancer Breast Cancer center.
Already taken its leading role at most hospitals in the Houston area is 3-D technology called Breast Tomosynethsis which experts say is the latest technology for early detection.
A 2-D mammogram takes two-dimensional images of the breast, one from the top and the other from the side. Tomosynthesis takes 15 successive images at slightly different angles across the breast. The images are assembled by a computer to produce clear, highly focused 3-dimensional images throughout the breast. Medical experts say it contributes to improved accuracy in screening results and pinpointing the location of a lesion.
“You can actually see inside the breast. It can penetrate the dense breasts better than it would before,” Judman said.
Cancer detection rates increase by as much as 30-to-40 percent using 3-D mammography with a 30-to-40 percent decrease in false positives. Also, dense breast tissue can look similar to cancer on a mammogram.
“Tomosynthesis makes it easier to distinguish between dense tissue and malignancies and allows radiologists to look at isolated areas of the breast in greater detail,” said Dr. Anne C. Kushawa, an associate professor in the department of diagnostic radiology at the MD Anderson Cancer Center.
The 3-D technology can also detect cancerous tissue that might have gone undiscovered through the 2-D mammogram or manual examination. Judman said one of their patients had two areas of cancer the size of a grain of rain in both breasts. They were spotted through Tomosynthesis.
“She said (it) saved her life,” Judman said.
She said some patients have concerns about the radiation they will be exposed to through the 3-D imaging process. It’s no more than during a 2-D mammogram.
“It’s a very low dose. It’s like flying an airplane from here to New York. You get the same radiation,” Judman said.
Most of the larger hospitals in the area have the 3-D Tomosynthesis equipment, which costs about $500,000.
“It could take awhile for everyone to get theirs. Eventually, the 3-D will become the ‘gold standard,’” Judman said.
An important development, Judman said, is that insurance companies are now covering Digital Tomosynthesis examinations. She said it took five years for that to happen.
“The women themselves fought for it,” Judman said. “It’s important for women’s care.”