This article first appeared in the St. Louis Beacon, Oct. 4, 2013 - Women can now access a new technology for yearly mammograms, at Missouri Baptist Medical Center in west St. Louis County and Boone Hospital Center in Columbia, Mo., that proponents say is better than standard mammography at detecting early cancers, particularly in women with dense breast tissue.
While standard mammography takes two views of each breast and creates a two-dimensional picture, the new technology, called breast tomosynthesis or 3D mammography, takes 15 pictures of each breast in a defined arc. It then uses a computer program to reconstruct the images into a three-dimensional picture. Instead of looking at one view, radiologists can peruse one millimeter “slices” of the breast to look for small cancers, says Dr. Geoffrey Hamill, Section Chief of Mammography and Breast Imaging at Missouri Baptist Medical Center.
“We have the ability to unfold breast tissue in multiple layers, rather than one layer,” Hamill said. “We hope we will find cancers smaller in size and thus affect a more successful treatment.”
In standard mammograms, dense tissue shows up as white, sometimes hiding small tumors that also show up as white on a mammogram. When radiologists can “step” through multiple views, they are better able to see the edges of irregular growths, he said. The new technology administers a slightly higher dose of radiation.
“Its best benefit will be in patients with dense tissue,” said Hamill. Over half of the women screened at Missouri Baptist Medical Center have dense tissue, he said. Because it presents a 3D view of the breast, Hamill said, the technology reduces the number of callbacks for women getting mammograms by 11 to 14 percent overall in studies conducted by Missouri Baptist and other sites.
Dr. Jennifer Drukteinis, a radiologist at Moffitt Cancer Center in Tampa, Fla., also favors 3D mammography. Drukteinis is a coauthor of “Beyond Mammography: New Frontiers in Breast Cancer Screening,” a review of breast cancer screening technologies in April's American Journal of Medicine.
“In my opinion, tomosynthesis is the most promising of the new technologies,” she said. “It eliminates a lot of that dense tissue overlap, so you can see masses hiding.”
Missouri Baptist did not have to buy new machines, just a computer program. Hamill said the medical center made the decision a few years ago to purchase mammography machines that would be compatible with 3D mammography, once the technology became available.