Tomosynthesis or “3D” mammography is a new type of digital x-ray mammogram which creates 2D and 3D-like pictures of the breasts. This tool improves the ability of mammography to detect early breast cancers, and decreases the number of women “called back” for additional tests for findings that are not cancers. Show
During a “3D” exam, an X-ray arm sweeps in a slight arc over your breast, taking multiple low dose x-ray images. Then,
a computer produces synthetic 2D and “3D” images of your breast tissue. The images include thin one millimeter slices, enabling the radiologist to scroll through images of the entire breast like flipping through pages of a book, and providing more detail than previously possible. The “3D” images reduce the overlap of breast tissue, and make it possible for a radiologist to better see through your breast tissue on the mammogram. Why is there a need for tomosynthesis breast exams? What are the benefits? With conventional digital mammography, the radiologist is viewing the tissues of your breast overlapping on flat images. This tissue overlap can sometimes make cancers hard to detect. Also, overlap can sometimes create areas that appear abnormal, but require that you be “called back” for additional tests to determine that cancer is not present (so-called false positives). Tomosynthesis or “3D” mammography directly addresses the current limitations of standard 2D mammography. Multiple studies have shown that “3D” mammography increases the detection of breast cancer by approximately 25%, and decreases the number of false positive call backs by approximately 15%. What is the difference between a screening and diagnostic mammogram? A screening mammogram is done in women who have no breast signs symptoms. A diagnostic mammogram is done in women who have been “called back” from a screening mammogram, or who have a clinical breast symptom such as a lump. What should I expect during the 3D mammography exam? Having a “3D” mammogram is similar to a having conventional digital mammogram, including the amount of compression of the breasts and the time in compression. The main difference is that the X-ray arm sweeps in a slight arc over your breasts. Why is compression important in mammography?
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. Does 3D mammography have a higher radiation dose? Because Stanford has invested in software that creates both the synthetic 2D and “3D” images from the same acquisition, the synthetic 2D and “3D” radiation dose is very similar to that of standard 2D digital mammograms in the USA.
Sources: 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 combo-mode to Hologic 2D FFDM. 3 Skaane P, Gullien R, Eben EB, et. al. Reading time of FFDM and tomosynthesis in a population-based screening Program. Radiological Society of North America annual meeting. Chicago, Il, 2011
 Mammography topicsFuture of Breast Cancer Screening with Digital Breast TomosynthesisFuture of Breast Cancer Screening with Digital Breast TomosynthesisFull-field digital mammography (FFDM) is currently the gold standard in breast cancer screening.1 It delivers high-resolution images of the breast, but it has a limitation that’s inherent to the acquisition method: tissue superimposition. To resolve this issue, in recent years
digital breast tomosynthesis (DBT) has been introduced in clinical practice. It provides 3D information about breast tissue by acquiring images at different angles, and it offers better cancer detection rates.2 DBT has become an established method in the clinical routine, and in the near future it may replace digital mammography as the breast screening modality of choice. What do our clinical experts have to say?The latest results of clinical trials were presented at a Breast Care Day symposium at the ECR 2019. The studies were analyzed in terms of their effectiveness in population screening, and the remaining knowledge gaps were identified. What should the future of breast cancer screening with digital breast tomosynthesis look like?The future of breast cancer screening with DBT is a highly debated topic. There are various factors to be considered. Associate Prof. Dr. Ioannis Sechopoulos (Raboud University Nijmegen/NL) gives an overview of the key parameters for screening programs, with a special emphasis on the role of dose. (ECR, March 2019) Conclusion from the Malmö Breast Tomosynthesis Screening Trial – a concept for breast screening The Malmö Breast Screening Trail focuses on DBT screening performance, effectiveness and reduced reading time. Prof. Dr. Sophia Zackrisson (Lund University, Malmö/Sweden) concludes that 1-view tomosynthesis with minimum compression increases cancer detection and can be feasible in screening. (ECR, March 2019) Related Products, Services & ResourcesRelated abstractsView of future screening programs: Conclusion from the Malmö Breast Tomosynthesis Screening Trial – A concept for breast screening Sophia Zackrisson; Malmö, SwedenAccording to some of the important principles of screening established by WHO in 1968, a screening test should be fast, safe, efficient, and acceptable for the target population. Screening with 2D mammography fulfills many of these prerequisites, but how will digital breast tomosynthesis, DBT, fit in? The organization and workflow in mammography screening is long-standing and well-established in many countries, and changes may have a great impact on these issues. This talk will focus on the facts about digital breast tomosynthesis regarding screening performance, effectiveness, and possible measures to reduce reading time. When planning the Malmö Breast Tomosynthesis Screening Trial we took the principles of screening into consideration and used 1-view DBT and reduced compression. Furthermore, artificial intelligence in combination with the radiologist opens up possibilities for further future improvements. Did this information help you?1 Perry N, Broeders M, Wolf C de, Törnberg S, Holland R, Karsa L von. European guidelines for quality assurance in breast cancer screening and diagnosis. Fourth edition – summary document. Annals of oncology official journal of the European Society for Medical Oncology/ESMO 2008;19(4):614-622. 2 Zackrisson S, Lång K, Rosso A, Johnson K, Dustler M, Förnvik D, Förnvik H, Sartor H, Timberg P, Tingberg A, Andersson I. One-view breast tomosynthesis versus two-view mammography in the Malmo Breast Tomosynthesis Screening Trial (MBTST): a prospective, population-based, diagnostic accuracy study. Lancet Oncol. 2018;19:1493-1503. What is tomosynthesis with CAD?Tomosynthesis is an advanced type of mammography. The Food and Drug Administration (FDA) approved it in 2011. During tomosynthesis, multiple images of the breast are taken. These images are sent to a computer that uses an algorithm to combine them into a 3-D image of the entire breast.
What is a mammogram with CAD and tomosynthesis?A 3D mammogram (breast tomosynthesis) is an imaging test that combines multiple breast X-rays to create a three-dimensional picture of the breast. A 3D mammogram is used to look for breast cancer in people who have no signs or symptoms.
What is a digital mammogram with CAD?Computer-aided detection (CAD) for mammography
CAD for mammograms is used to analyze mammographic images and check for the presence of breast cancer. The CAD system analyzes digital information collected by a mammogram and then computer software searches for abnormal areas of density, mass or breast calcification.
What is digital mammography with tomosynthesis?Tomosynthesis or “3D” mammography is a new type of digital x-ray mammogram which creates 2D and 3D-like pictures of the breasts. This tool improves the ability of mammography to detect early breast cancers, and decreases the number of women “called back” for additional tests for findings that are not cancers.
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Digital screening mammogram with cad and tomosynthesis
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