3D breast tomosynthesis uses high-powered computing to convert digital breast images into a stack of very thin layers or “slices” building what is essentially a three-dimensional mammogram. The 3D tomosynthesis technology makes it possible for radiologists to see breast tissue detail in a way never before possible. Fine details are more clearly visible, no longer hidden by the tissue above and below.
On the day of your exam, do not wear lotion, deodorant or powder under your arms or on your breasts as these products may interfere with the images taken of the breasts. You will need to remove clothing from the waist up. We recommend that you dress comfortably in a two-piece outfit to make it easy to undress from the waist up. You will be provided with a short gown that opens in the front. Inform our technologist of any problems you may be experiencing with your breasts.
Our Radiologic Technologist (a woman specializing in mammographic imaging) will position you standing near the machine and your breast will be placed on a contoured platform and compressed with a contoured translucent plastic plate. During compression the machine will move in a quick arc over the breast as it takes a series of images at various angles. It is necessary to compress the breast in order to:
- Even out the breast thickness so that all of the tissue can be visualized.
- Allow use of a lower x-ray dose.
- Hold the breast still to eliminate blurring of the image caused by motion.
- Reduce x-ray scatter to increase picture sharpness.
- Better cancer detection – Recent large clinical studies have demonstrated a significant increase in the rate of cancer detection with 3D tomosynthesis over conventional mammograms. Furthermore, the cancers detected are often smaller and therefore caught in time for a potential cure.
- Reducing the need for additional testing – 3D mammography is better at distinguishing harmless abnormalities from real cancers leading to fewer “callbacks. A “callback occurs when a mammogram picks up something suspicious and the Radiologist requests the patient to return for additional views or an Ultrasound. This naturally worsens if she is called back. With the addition of 3D mammography, patients can be confident that they are getting the best test possible resulting in fewer callbacks.
The American Cancer Society and American College of Radiology screening guidelines recommend women of average risk begin screening mammograms at age 40 and once a year thereafter. Women with higher risk factors including family history of breast cancer should consult with their physician about beginning screening at a younger age.
Digital mammography uses a specially designed digital camera and a computer to produce an image that is displayed on a high-resolution computer monitor. Although an adequate breast cancer screening tool, digital mammography produces only a 2-dimensional picture of the breast. Traditional mammograms take only one picture, across the entire breast, in two directions: top to bottom and side to side flattened images.
With 3D mammography or digital breast tomosynthesis multiple pictures are collected and reconstructed into thin slices of breast tissue. Breast tomosynthesis uses high-powered computing to convert digital breast images into a stack of very thin layers or “slices building what is essentially a three-dimensional mammogram This technology makes it possible for the radiologist to see breast tissue detail in a way never before possible.
Instead of viewing all the complexities of breast tissue in a flat image, the doctor can examine the tissue a millimeter at a time. It is similar to being able to read each page of a book rather than trying to peer through all the pages at once. The radiation dose for 3D mammography is equal to that of conventional mammograms.
A screening mammogram is a routine test for women who are symptom-free. Mammography plays a central role in the early detection of breast cancers because it can show changes in the breast up to two years before a patient or physician can feel them. Research has shown that annual mammograms lead to early detection of breast cancers, when they are most curable and breast-conservation therapies are available.
A diagnostic mammogram is used to evaluate a patient with abnormal clinical findings such as a breast lump or lumps that have been found by you or your doctor. Diagnostic mammography may also be done after an abnormal screening mammography in order to evaluate the area of concern on the screening exam. When the examination is complete, you will be asked to wait until the radiologist determines that all the necessary images have been obtained.
Peninsula Imaging is accredited by The American College of Radiology which recommends:
- Women of average risk at 40 years of age should begin annual screening mammograms
- Women with higher risk factors should consult with their physician on when screening mammography should begin
- Women with higher risk factors may benefits from supplemental screening modalities such as breast ultrasound and breast MRI
A routine screening mammogram will take about 15 minutes. The technologist will compress the breast briefly before and during x-ray exposure. You will feel pressure on your breast as it is squeezed by the compression paddle. Our technologists are highly experienced and understand the need to balance patient comfort with optimal image quality. Be sure to inform the technologist if pain occurs as compression is increased. If discomfort is significant, less compression will be used. Patients with breast implants, large breasts or patients requiring special assistance may require more time for their procedures as well as patients requiring diagnostic exams.
Peninsula Imaging Radiologists will send you a letter detailing your test results. Results are also forwarded to your referring physician. The vast majority of women receive a negative or normal report. Note: With the implementation of 3D mammography patients will be called back less frequently. However, it is not unusual to be called back within a few days of your mammogram with a request that you return for additional mammograms or an ultrasound exam of the breast. The great majority of “call-backs” prove to be negative or confirmatory of benign findings such as cysts, benign calcifications or lymph nodes. Therefore, if you are called back, please don’t panic! The vast majority of screening mammograms will not show anything worrisome. In the event that one does, however, Peninsula Imaging has all the resources available to provide further work up including ultrasound and MRI. We encourage one on one interaction between patients and radiologists, who are more than willing to go over your findings. If it determined that a biopsy is necessary, they will personally navigate you through the process in a timely way, so you never feel as if you’re alone.
Your mammogram report will include your breast density composition. Dense breast tissue is very common and is not abnormal. About 40% of women have dense breasts. However, it may be associated with increased risk of breast cancer as it can be harder to find cancers in breasts that are dense. As 3D mammography allows the radiologist to view the breast in 1 millimeter layers this helps overcome the challenge of detecting cancers in dense breasts. A breast MRI is sometimes recommended for women with dense breasts.