When I took a tour of the newly built Zion Crossroads Primary and Specialty Care, one of the most memorable parts was seeing a new mammography technology. Mammography technologist Lorie Hubbard passionately explained that this technology, tomosynthesis, catches breast cancers earlier and finds fewer false positives compared to standard mammography.
At 30, I’ve never had a mammogram, but my aunt was only in her early 40s and had two young children when she was diagnosed with breast cancer. I know I need to pay attention to research and new technology. I’ve also experienced the panic of the “We need you to come back in for more tests” call, only to go back to the doctor and find out it was nothing.
So, tomosynthesis, also known as 3D mammography, sounds promising. As Dr. Jennifer Harvey, MD, director of Breast Imaging, explains it, “Most new tests that find more cancers also find more false positives, but tomosynthesis is different. Tomosynthesis finds 30 percent more cancers (compared to standard mammography) but also finds 30 percent fewer false positives.”
What is Tomosynthesis?
Tomosynthesis is also called 3D mammography because it produces many images that each show a tiny slice of the breast, allowing the breast radiologist to see it from multiple angles. A standard mammogram produces a static image where overlapping tissue can hide or mimic cancers — meaning patients get an unnecessary dreaded callback or, worse, their cancer isn’t caught until later.
For every 100 patients who get standard mammograms, 10 to 15 have to come back for more testing, such as an ultrasound, additional images or even a biopsy, Harvey says. With tomosynthesis, only 7 to 10 come back.
Tomosynthesis may especially benefit women who:
- Are higher risk for breast cancer due to family history or previous abnormal biopsies
- Have dense breasts
But Harvey recalls one patient who had fatty, not dense, breast tissue, and tomosynthesis found two 4-cm cancers. She had a less common type of cancer that was hard to see on a standard mammogram.
3D Mammography v.s. Standard Mammography
Most women don’t really notice the difference between a standard mammogram and tomoynthesis, Harvey says. Some find tomosynthesis slightly more comfortable because the compression paddle is tilted instead of flat.
The FDA approved tomosynthesis in 2012, and UVA participated in the studies that prompted the approval.
Tomosynthesis exposes the patient to 80 percent more radiation than a standard mammogram, but it’s well below the Food and Drug Administration’s upper limit, Harvey says. And since tomosynthesis finds fewer false positives that require additional imaging, patients may ultimately be exposed to less radiation.
Getting a Mammogram at UVA
Talk to your doctor about your breast cancer risk and the best mammogram for you. “Women often wait for their doctor to tell them what screenings to do,” Harvey says. “But it’s completely fine for women to self-request a mammogram, and you don’t have to have a doctor’s order to get a screening mammogram, including tomosynthesis.” You can also choose the facility. In the Charlottesville area, only UVA currently offers tomosynthesis.
Watch a 3D Mammogram
Check out this video of tomosynthesis: