For all women — and particularly women with dense breasts — a 3D mammogram can make a significant difference in detecting tumors.
Approved by the U.S. Food and Drug Administration in 2011, 3D digital breast tomosynthesis, also known as 3D mammography, allows radiologists to better visualize breast tissue with X-rays.
The 3D mammogram captures multiple slices of the breast at multiple angles, said Dr. Monica Yepes, chief of breast imaging and associate professor of radiology at Sylvester Comprehensive Cancer Center at U-Health. The images are brought together to create a reconstruction of the breast.
“It is like getting multiple views of an apple where you can actually examine each slice,” Yepes said.
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The 3D images are thin-sectioned slices of the breast, which allow small lesions to be better evaluated than on a traditional 2D image, which give views from above and the side.
“All women benefit from 3D mammography, especially women with dense breasts,” said Dr. Kate Lampen-Sachar, breast radiologist at the Miami Cancer Institute, part of Baptist Health South Florida. “This is helpful for women with dense breast tissue, which can hide small lesions.”
The new technology will help in early detection, especially in light of the new screening guidelines that the American Cancer Society (ACS) approved last October. The guidelines recommend women with an average risk of breast cancer should begin yearly mammograms at age 45.
Women at a high risk of breast cancer, due to family history, need to begin screening earlier and more frequently, according to the ACS. Yepes noted that women with genetic mutations or strong family history may need to have mammograms earlier than age 40, and they may need further testing, such as an MRI and ultrasounds.
At age 55, women should have mammograms every other year. For women who prefer to have yearly mammograms, they should continue to do so, according to the ACS.
One in six breast cancers occur in women aged 40-49, according to the American College of Radiology and Society of Breast Imaging. Indeed, the incidence rate for women aged 40-44 is twice that for women ages 35-39 (122.5 vs. 59.5 per 100,000 women). For ages 45-49, the rate is 188.6 per 100,000 women. The median age at diagnosis: 62, according to the National Cancer Institute.
The percentage of women who have had mammograms within the past two years is evenly split across racial lines, although differences vary among ethnic groups.
According to the ACS, 69 percent of non-Hispanic white women 45 and older have had a mammogram within the past two years, based on 2013 data. During the same period, 70 percent of non-Hispanic black women 45 years and older had a mammogram within the past two years. Among Hispanic women, the rate is 64 percent.
But the new ACS guidelines, which call for women at age 40 to have the option of having a mammogram instead of strongly recommending the practice, could have lasting effects on the health of minorities. Black women tend to be diagnosed with a more advanced breast cancer at a younger age and are more likely to die of breast cancer than white women, studies have shown. Reproductive factors, breast cancer biology and lack of access to healthcare appear to play a role in the disparities.
Hispanic women have lower rates of breast cancer and breast cancer mortality compared with non-Hispanic black and white women, according to the ACS. But, breast cancer is still the leading cause of cancer deaths among Hispanic women. This may be due to lower mammography rates as well as delays in follow-up after an abnormal mammogram, according to the ACS.
With 3D mammography added to the arsenal against breast cancer, great strides in detection should continue to be made, medical experts say. Studies have shown a 40-percent increase in breast cancer detection with 3D technology, Yepes said.
“It is a very promising technology,” Yepes said. “We expect it to become the standard of care in the future.”