Column: 3-D exams find cancer early

Commentary by Kandice Ludwig, MD

Mammograms are even more valuable in detecting early breast cancer thanks to the latest advancement in digital mammography – 3-D breast tomosynthesis. Unlike traditional two-dimensional mammograms, 3-D tomosynthesis acquires multiple, low-dose images of the breast at different angles. A computer program then consolidates the images to produce a series of “slices” that can be viewed as a 3-D construction of the breast.

While the patient’s experience with 3-D tomosynthesis is similar in terms of length of testing, amount of radiation and comfort, this latest technology offers significant advantages:

More images mean better detection. With additional imagery and tomosynthesis’ 3-D modeling feature, radiologists are able to identify even small breast lesions in very early stages. Early detection of breast cancer dramatically improves outcomes, increases survival rates and also offers women more – and often less toxic – treatment options. Due to the increased clarity and availability of more views, three-dimensional imaging is particularly beneficial for detecting suspicious lesions in women (often younger) with dense breast tissue.

3-D imagery improves accuracy, reduces “call backs.” The limits of two-dimensional mammography – primarily the inability to see fine characteristics and to clearly distinguish between possible lesions and overlapping tissue – frequently result in a need to call women back for further imaging or other tests, such as ultrasound or biopsy. Sharp digital 3-D images make it easier for radiologists to clarify an issue without a return visit. This reduces stress for women and avoids costs associated with additional tests.

Currently, 3-D tomosynthesis is covered by Medicare and some private insurance companies. Women should check with their insurance provider to see how coverage compares to traditional digital mammography. The American Cancer Society recommends that women of average risk (those with no personal history of breast cancer and limited family history) begin annual screenings at age 40. Your primary care doctor is a great resource for discussing your personal risk for breast cancer and helping to determine which mammography option is right for you.

Kandice Ludwig, MD, medical director, IU Health North Hospital Breast Care, specializes in breast disease and breast surgery. She is a guest columnist located at IU Health North Hospital, 11700 N. Meridian St., in Carmel. She can be reached by calling the office at 688.5155.

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