Tuesday, September 24, 2019

3-D Mammography Advantages ~ Breast Tomosynthesis

by Dr. Robin Hape, General Surgeon, Providence St. Joseph Medical Center, Polson, MT 


Editor’s note: I was diagnosed with ductal carcinoma in-situ in my right breast after a 3-D mammogram detected an early-stage cancer in February 2019. I was called back for a second screening. When I told the medical technician that I could not feel anything, she laughed and responded “it is like trying to feel a grain of sand in a bowl of jello.” Since February I’ve had a lumpectomy and the sentinel node removed plus five days of high-dose radiation. I was finished by June 5. I am totally SOLD on 3-D mammography. I asked Dr. Robin Hape, general surgeon at Providence St. Joseph Medical Center in Polson, who performed my lumpectomy,  to talk about his experience with 3-D Mammography.      Valerie Lindstrom

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There are several advantages to Breast Tomosynthesis or more commonly referred to as 3-D Mammography.  We have had this technology in Polson for a little over a year.

Earlier detection of breast cancer.  It is not uncommon for us to find breast cancers very very early now.  Several of the new breast cancer patients I have cared for in the last year have cancers in the range of 3 – 4 mm.  That is much better than the old machine
Fewer call-backs.   With the old technology it was not uncommon for women to be called back for additional views.  Skin folds or dense breast tissue was harder to see through with the old machine resulting in call backs for compression views which were uncomfortable for women.  Call backs are about 40 percent less with the Tomosynthesis machine.  That reduces cost, pain and anxiety.

Works better for women with dense breast.  Standard mammograms have trouble “seeing through” dense breast tissue. This is common in younger women and about 30 percent of all women.  It is possible for a breast cancer to “hide” in these women and women with very dense breasts are also about 1.5X higher risk for developing breast cancer.  Tomosynthesis does a much better job for younger women and women with dense breasts.

Radiation exposure.  The radiation exposure, time for the exam and compression are about the same for Tomosynthesis as for a standard mammogram.  The tomosynthesis machine has heated paddles so it is a little more comfortable.  The amount of radiation from a mammogram is minimal.

Breast cancer screening recommendations for women


There is a lot of confusion about the standard breast cancer screening recommendations.  Here are the recommendations made by almost every reputable medical society in America.

  • Average risk women should get their first mammogram at age 40 and annually as long as they are healthy.
  • If a women has a strong family history of breast cancer they should start getting mammograms 10 years before the age of their youngest relative’s diagnosis.  For example, if a patient’s mother was diagnosed with breast cancer at age 45, the patient should start getting mammograms at age 35. 
  • Considering all risk factors a physician may recommend more aggressive screening such as mammograms twice per year or breast MRI’s.

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