What is Different about 3D Mammography?
3D mammography is an advancement in breast imaging that is a more accurate procedure in the fight against breast cancer. Greater accuracy means better breast cancer detection and a reduced chance of additional screenings. Extensive research published by imaging researchers established 3D as superior to conventional 2D mammography. This has been confirmed in the Journal of the American Medical Association (JAMA) which supports the clinical superiority of 3D technology.
The benefits of 3D mammography include:
- Detection of breast cancers 15 months earlier than conventional 2D mammography
- Callback exams to obtain additional views are reduced by 40%
- Identifies 41% more invasive cancers than conventional mammography alone.
How does 3D Mammography Work?
With 3D mammography at Salem Radiology, a female technologist will position you and gently compress your breast. An x-ray arm will sweep over the breast in a slight arc, taking multiple breast images in just seconds. A physician radiologist will then carefully examine your images on a computer that has been specially designed for this purpose. The physician radiologist will be able to view your breast tissue in one millimeter layers instead of viewing all of the complexities of your breast tissue in one flat image.
Screening & Diagnostic Mammography
Mammography is a type of imaging procedure that uses x-rays to produce pictures of the breast. There are two types of exams, screening and diagnostic.
Doctors use screening mammograms as a tool to detect breast abnormalities in women not experiencing any symptoms. Screening mammograms play a vital role in early cancer detection because they can find tumors before they are big enough to feel. Early detection of small breast cancers by screening mammography greatly improves a woman’s chances for successful treatment. Screening mammography is generally recommended every year for women over 40 years of age.
Diagnostic mammograms are used to examine a patient who has a specific concern or suspicious breast changes, or to follow up on an abnormality found during a screening mammogram. They involve additional and more magnified views of the breast, lymph nodes, and surrounding tissue, which requires more time.
Occasionally, women who have a screening mammogram will be asked to return for additional views; however, this occurs 40% less often with 3D mammography. This is typically not due to any quality concerns with your previous images, but can be due to the radiologist having additional questions as a result of your unique breast anatomy.
Pre-cancerous breast microcalcifications
A faint or subtle opacity that warrants additional pictures
Area of architectural distortion where the breast tissues appears as puckered or falling into itself.
At Salem Radiology Consultants, a radiologist with certification as a specialist in the interpretation of breast images will read your diagnostic mammogram immediately following your exam to determine if additional imaging (an ultrasound or breast MRI) is necessary before you leave the facility. If your diagnostic mammogram reveals any area of concern, we will immediately consult with your physician to schedule a biopsy procedure. The biopsy will obtain a sample of the suspicious breast tissue, which will be examined under a microscope to determine whether it contains cancer cells. Women with breast implants or a personal history of breast cancer will usually require the additional views used in diagnostic mammography or magnetic resonance mammography (breast MRI).
At Salem Radiology Consultants we provide the added benefit of a “computerized second opinion.” Using a sophisticated computer analysis system called CAD, or computer-aided detection, every mammogram performed at Salem Radiology Consultants is processed to identify any areas within the images that are suspicious for cancer. A computer screen displays your images and electronically marks any areas with unusual densities or calcifications. After thoroughly reviewing your films, the radiologist then consults the CAD system before issuing a final report. Clinical studies have demonstrated that combining these two processes—radiologist interpretation followed by the CAD analysis—increases the early detection of breast cancer by as much as 19%.
How to prepare:
Please do not wear any lotion or deodorant on the day of your exam. You will need to remove all jewelry and clothing from the waist up, and you will be given a gown for your exam. Make sure you tell your technologist about any problems you are experiencing with your breasts.
Length of exam: Many of our patients schedule mammograms in coordination with their work schedules or treat themselves to a special day as a reward for completing their annual mammogram. At SRC, we take pride in performing mammograms in a caring and gentle manner, understanding that you would rather spend your time enjoying a lunch or manicure with friends than sitting in a medical imaging facility. Depending on whether you are having a screening or diagnostic mammogram, we will have you on your way in 20-30 minutes.
Other breast imaging techniques:
Magnetic resonance mammography (Breast MRI)
A breast MRI is not a substitute for a mammogram, but is a valuable tool for determining the development of breast cancer when a physical exam and other standard imaging techniques do not provide clarity. Breast MRI is very sensitive for detecting the presence and extent of breast cancer, as it can detect blood vessels newly “grown” to supply blood to a tumor. Please note that hormonal fluctuations in women throughout the month can cause breast tissue changes that can impact the results of your scan. For this reason, we recommend that women schedule their breast MRI on the second or third week of their menstrual cycle or after discontinuing hormone replacement therapy for a period of four weeks.
At SRC we have a unique scanning technique that allows us to image both breasts during a single scan with a single dose of contrast. Most facilities scan only the suspicious breast or scan each breast separately, which involves two separate scans with two doses of contrast. With SRC’s unique scanning technique, we will always scan both breasts with the highest level of image quality in half the time and with half the gadolinium dose, which we believe sets the highest standard of clinical quality for breast MRI.
American Cancer Society Recommends Breast MRI
The American Cancer Society has updated its guidelines for breast cancer screening and is now recommending that women who are at an extraordinarily high risk of developing breast cancer have an annual MRI performed of both breasts, in addition to annual mammography. Women considered to be at extraordinarily high risk would be women who:
- are known carriers of the two breast cancer mutations that are easily testable, the BRCA1 and BRCA2 genes * are first-degree relatives of someone with one of those gene abnormalities, but have not yet been tested * have a significant family history, who by a breast-cancer risk model, would have a lifetime risk of somewhere between 20-25%.
- The American Cancer Society recommends that women in these groups still receive a mammogram because the complement of the mammogram and a breast MRI actually provides the highest pickup rate of early breast cancers. Consistent with the American Cancer Society guidelines, the radiologists at SRC perform MRI guided biopsy procedures.
Breast Ultrasound
An ultrasound of the breast is an excellent imaging technique for determining whether a breast mass previously identified is filled with fluid or is solid. Breast ultrasound is a useful imaging tool, but has specific application for evaluating breast abnormalities after they have been detected by mammography. It is, however, far less effective at searching the breast tissue for unknown abnormalities and therefore is not a substitute for a mammographic examination.
Ultrasound-Guided Breast Biopsy
In some cases, it is not possible to tell from the imaging studies alone whether an abnormality is benign or cancerous. When this happens, ultrasound guided breast biopsy is a highly accurate and minimally invasive way to provide the answer. During this procedure, a specially trained ultrasound technologist and a radiologist will place an ultrasound wand on the breast over the site of the lump. After applying a local anesthesia to the area, the radiologist will carefully guide a biopsy needle into the breast mass. The needle is designed to remove a small sample of the suspicious tissue that can then be sent to a laboratory pathologist to determine if it is benign or cancerous.
