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Newest Mammogram Technology Provides 3-D Imagery

Tuesday, January 21, 2014 - Campus News - Contact Theresa Green, (405) 833-9824
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There are 3-D movies, 3-D video games and now, 3-D mammograms. In entertainment, three dimensions add to the viewing or gaming experience. In medicine, adding another dimension helps radiologists spot tumors that might otherwise be missed. It's called breast tomosysthesis, a mammography system that utilizes multiple images and a high-powered, computer software system to build a 3-D view of the breast.

"The first time I saw breast tomosynthesis, I knew we had to have it," said Elizabeth Jett, M.D., director of the OU Breast Institute. "I have not met the radiologist who, once they see this, wouldn't rather read tomosynthesis." 

A breast tomosynthesis exam is similar to a traditional, digital mammogram. However, during tomosynthesis, 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 to the patient is about the same as that of a traditional mammogram.  

"In a typical mammogram, the breast is compressed and all of the tissue is superimposed on the image," Jett said. "What tomosynthesis gives us is the ability to scroll through the mammogram one millimeter slice at a time."

As a result, tumors that might be obscured in a normal mammogram can be seen. Jett said in studies where traditional mammography found four breast cancers in every 1,000 women examined, breast tomosynthesis found seven.

"They aren't even necessarily tiny tumors. Compressed breast tissue can hide big tumors too. In the studies on tomosynthesis, the cancers found that were not seen on mammography ranged from a few millimeters to four centimeters (over 1.5 inches) in diameter," Jett said. 

The other key advantage is for women with dense breast tissue because breast tissue that is superimposed in traditional mammography can mimic a mass. With tomosynthesis, though, the radiologist can scroll through the layers and see that it is just breast tissue, thereby eliminating the need for additional screenings.

"So we are calling back fewer women and having fewer diagnostic workups. That is what is so compelling about this technology. In fact, our call backs have been reduced by about 40 percent with tomosynthesis," Jett said.

She said regular mammography is still great for women who have relatively fatty breast tissue. Fatty breast tissue is easy to see through on a traditional mammogram. However, Jett believes the popularity of tomosynthesis will grow as technology advances and allows for increased sensitivity and a reduction in radiation too. 

The OU Breast Institute is one of several facilities in Oklahoma that are already offering breast tomosynthesis. Although the cost is slightly higher when compared to traditional mammography, Jett said the potential savings are substantial when one considers that tomosynthesis helps eliminate the need for unneeded additional screening tests by reducing the number of false positives. In addition, it can help bring improved outcomes for cancer patients by catching tumors early that might be missed with traditional mammography. 

Jett said there is not a standardized payment schedule yet for breast tomosynthesis with insurance companies. Therefore, some facilities bill for a traditional mammogram, while offering the enhanced technology as an option to patients. Others charge as much as $50 to $100 more for breast tomosynthesis. 

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