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What is Breast Tomosynthesis or 3D mammography?

Breast Tomosynthesis, or 3D mammography, is a new, FDA-approved imaging modality. Instead of a single image 2D image, 3D Tomosynthesis captures approximately 15 low-dose digital “projection” images as it arcs over the breast during a short four-second scan. These images are then digitally reconstructed into a series of high-resolution one millimeter slices that can be reviewed individually or played back in a cine loop.

Clinical trials have shown that Tomosynthesis improves detection of invasive cancers by up 40% compared to traditional 2D mammography alone, with the greatest benefit in women with dense breast tissue. In addition, it reduces the rate of recall from screening by up to 20%.

How is 3D Mammography different than traditional digital or 2D mammography?

While traditional digital mammography is still one of the most advanced technologies available today, it is only a two-dimensional picture of the breast. Since the breast is often composed of pockets of dense tissue surrounded by fat, when X-rayed, the overlapping tissue in the image may result in difficulty viewing signs of early cancer.

Instead of viewing all the complexities of breast tissue in a single flat image, Tomosynthesis allows the physician to examine the tissue one millimeter at a time. Fine details are therefore more visible, no longer hidden by the surrounding tissue.

Why is there a need for 3D mammography?

According to a study published in the Journal of the National Cancer Institute, women with greater than 50 percent breast density on mammographic study had triple the risk of breast cancer compared with women who had less than 10 percent density.1 While standard 2D mammography has advanced greatly over the years and remains the gold standard for breast imaging for the majority of women, 3D Tomosynthesis improves breast cancer detection by up to 40%, and the greatest benefit is seen in women with dense breast tissue.

Who is a candidate for Tomosynthesis?

Tomosynthesis helps detect cancers earlier and more effectively than traditional mammography for all women, especially those with dense breast tissue. Breast density is evaluated during a mammogram and will appear in all screening mammogram reports. A patient can learn if her breasts are dense by asking her physician or the radiologist who performs her routine mammogram.

Approximately 75 percent of women in their forties have dense breasts, and this percentage typically decreases with age – with 54 percent of women in their fifties and 42 percent of women in their sixties having dense breasts.2

Do all hospitals or breast care centers offer Digital
 Breast Tomosynthesis?

No. Hoag was the first hospital in California and one of a few in the United States to offer this advanced imaging modality as part of its comprehensive breast imaging services. Hoag Breast Center was one of eleven test sites nationwide designated to participate in the clinical trial for Tomosynthesis, which ultimately resulted in FDA approval of the technology in February 2011. Hoag’s specialized breast radiologists are experts in utilizing this modality and are some of the nation’s leading experts in breast care.

Which Hoag locations provide Tomosynthesis?

This screening technology is offered at all seven Hoag imaging centers across Orange County. As with all mammograms, patients must first see their physician, who will order a screening or diagnostic mammogram.

What can patients expect from a 3D mammogram?

During a Tomosynthesis exam, the X-ray arm sweeps in a slight arc over the breast, taking multiple breast images in seconds. Very low X-ray energy is used so exposure is about the same as that of a traditional mammogram. Patients will likely not notice a difference between Tomosynthesis and a traditional digital mammogram exam.