Cancer can’t hide.
Or at least not as well as it used to, since 3D mammography technology, or digital breast tomosynthesis, is being used by radiology staff at East Alabama Medical Center.
Although 2D mammograms are still offered, women can choose to be evaluated through the newer system, which can detect breast cancer at a higher rate of 20 to 65 percent, according to Dr. Matthew Dobbs, an EAMC radiologist. Acquired in April and May, two 3D machines each are being operated at EAMC and Auburn
Now, radiology staffers are embracing the advanced capabilities.
“Traditionally, women would come in for a mammogram and have two X-rays or views taken of the breast,” Dobbs said. “And then now with the 3D, within four seconds for each breast, it takes a very thin slice look through each breast that we can scroll through, similar to like a CAT scan. It’s similar to going from a chest X-ray versus a CAT scan of the chest. We’re able to see in a lot more detail.”
Finding cancer as early as possible serves as the benefit of having mammograms, which can result in a better prognosis and greater chance of survival, Dobbs explained. Through traditional mammograms, a lot of tissue gets superimposed on top of each other during X-rays. However, 3D enables radiologists to evaluate matters through “slice-by-slice” images, allowing for clearer observations to help determine if anything suspicious is cause for alarm.
Another way to explain it, Dobbs highlighted, is with a loaf of bread.
“Previously, we would shoot an X-ray in at one end of the loaf of bread and then detect on the other,” he said. “So anything in that loaf of bread is all going to end up flattened down on that one image. So, with this one, it’ll do it slice by slice so we can kind of look at each slice of bread, if you will, as you go through, with none of the artifacts from the other slices next to it.”
This, of course, helps radiologists key in on subtle signs of cancer, whereas these signs would have a greater chance of hiding with the 2D method.
“You can have like a little cancer dot here, and then right in front of it some benign, non-cancerous, real dense tissue,” Dobbs said. “As that X-ray beam comes through, it’s going to hit both of those, so it may blur out what is actually cancer or the suspicious area.”
Besides the greater detection rate, 3D mammograms also help reduce call-backs for reexamination by 15 to 30 percent, Dobbs also highlighted. As a result, women experience less anxiety.
“We’re not guaranteeing you’re not going to get a call-back,” Dobbs said. “We’re just saying that if you previously had 10 women come back out of a hundred, we may have seven come back if there’s a 30 percent reduction.”
Brandi Jones, mammography supervisor at EAMC, favors the new technology as well.
“When patients are called back for diagnostic mammograms – and they do have to come back and have more pictures taken – now we’re not doing as many mammogram pictures,” Jones said. “Whereas before we had 3D, we were taking maybe five pictures, now we only have to take like one or two.”
Most women, or approximately 90 percent of patients, choose to be examined using the new technology, Dobbs said. Patients are asked which method they prefer, and EAMC Radiology Director Melinda Johnson said the 3D option doesn’t really involve more time or pressure.
“I am excited that we’re offering this to the public,” she said. “It’s beneficial.”
Like the 2D method, 3D screening mammograms are covered by most insurance companies, Dobbs said. Although Breast Cancer Awareness Month is on the horizon, Dobbs and Johnson emphasized the importance of women getting annual evaluations sooner rather than later, particularly once they turn 40.
“They don’t have to wait until October to take advantage of our new equipment,” said Johnson, who also noted that 12,000 mammograms are completed annually at EAMC and Auburn Diagnostic Imaging.
Although the new technology requires more time for radiologists to review the multiple images produced, Dobbs said the method is highly valued.
“The studies have shown it takes about double the time to read one, compared to the old way, because used to we would have four images to look at, and now we probably have 100 or 120 images to look at for a screening mammogram,” Dobbs said. “It takes us longer to get through them, but we wouldn’t want to go back to the old way, because we can see everything so much better now.”
Above all, of course, the advanced technology is great for patients, Dobbs concluded.
“It’s kind of the latest technology that’s sort of been tested in all academic centers and they’ve found that it’s not just a marketing gimmick,” he said. “It actually works and improves cancer detection and improves survival. So it’s a worthwhile investment.”