By Denise Mann
health day reporter
TUESDAY, March 14, 2023 (HealthDay News) — New scanning technology may detect more breast cancers and reduce the dreaded false positive rate, according to a large new study.
Now available in a growing number of healthcare facilities, tomosynthesis uses low-dose X-rays and computer reconstructions to create 3D images of the breasts to detect cancers. In contrast, traditional mammography creates 2D images of the breasts.
“Tomosynthesis is becoming the standard of care, and insurance usually covers it,” said study author Dr. Emily Conant, head of the division of breast imaging at the University of Pennsylvania, Philadelphia. “Look for places that offer this technology.”
The new study included data on more than one million women aged 40 to 79 who were screened with 3D or 2D digital mammography between January 2014 and December 2020 across five major health systems in the United States. Most women had at least two screening tests during the study period, for a total of almost 2.5 million screening tests.
Tomosynthesis detected 5.3 breast cancers per 1,000 women screened, compared to 4.5 per 1,000 women screened with 2D digital mammography. Additionally, there was a lower rate of false positives and recalls for additional imaging with tomosynthesis.
False positives happen when you are told you need follow-up testing, but no breast cancer is found. This can cause enormous anxiety, and there are increased costs and risks associated with further testing.
“With tomosynthesis, an x-ray beam takes multiple low-dose images in an arc over your head, and the computer reconstructs the breast so I can actually cycle through the layers of your breast tissue,” said Conant. “I can go through the tissue layer by layer to see if it’s a real lesion or not.”
Although 3D technology is more effective at detecting dense breast cancer than traditional 2D mammograms, it does not completely solve this problem, she noted.
“Very dense breasts look like a blizzard in some pictures, and because of the whiteness, you can’t find any lesions,” she explained. “Cancers are harder to see because they are obscured by white glandular tissue.”
Breast ultrasounds or MRIs after either type of mammogram will always be needed to screen for cancer in very dense breasts, she said.
The study was published online March 14 in the journal Radiology.
Breast cancer experts are excited about 3D breast cancer screening technology.
“Tomosynthesis is more detailed and advanced than traditional mammography,” said Dr. Katherina Sawicki Calvillo, breast surgeon and founder of New England Breast and Wellness in Wellesley, Mass.
The downside is that there is more radiation exposure. Still, “the benefits of better cancer detection outweigh this risk,” she said. “If a patient has been told she has dense breast tissue, she should seek out a center that offers tomosynthesis.”
Dr. Marisa Weiss, chief medical officer and founder of Breastcancer.org, agreed.
“For women at high risk of breast cancer, digital breast tomosynthesis-type mammography is a very important option that should be encouraged, as it allows you to know more quickly and more accurately if there is something worrying or if the coast is clear,” Weiss said.
More information
The Radiological Society of North America and the American College of Radiology have more on tomosynthesis.
SOURCES: Emily Conant, MD, professor, radiology, chief, division of breast imaging, University of Pennsylvania Hospital, Philadelphia; Katherina Zabicki Calvillo, MD, Founder, New England Breast and Wellness, Wellesley, Mass.; Marisa Weiss, MD, Chief Medical Officer, Founder of Breastcancer.org, Ardmore, PA; RadiologyMarch 14, 2023, online
