Tomosynthesis/3D Mammography

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Digital Breast Tomosynthesis (also known as 3D mammography) was approved by the FDA in February 2011. It is a modification of the current digital (2D) mammography which produces a 3D image of the breast.

Tomosynthesis creates multiple images or "slices" that step through the breast tissue. This allows the radiologist to see greater detail and helps reduce the impact of overlapping breast tissue. The process is performed at the same time as a normal mammogram, on the same scanner, with no noticeable differences in the experience or time expended for the patient.

 

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What are the Known Benefits?

Reduced Callbacks: Tomosynthesis allows radiologists to look at different layers of the breast tissue, helping to distinguish normal breast tissue from abnormal breast tissue. Information from these additional images provided on the screening examination is believed to lead to fewer callbacks and, therefore, less anxiety for women.

Better Visualization: Radiologists can better determine the size, shape and location of an abnormality with tomosynthesis.

Improved Sensitivity: By minimizing the impact of overlapping breast tissue, tomosynthesis may improve breast cancer screening and early detection.

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Who Should Consider 3D Mammography/Tomosynthesis?

All women may benefit from tomosynthesis; however, the benefit is greatest in women with dense breast tissue, because dense tissue can mask cancers and/or lead to false positives.

How do you know if you have dense breasts?
Density refers to the amount of glandular and connective tissue as compared to fatty tissue—not breast firmness—so a mammogram is the only way to determine breast density. You can either:

  • Speak with your physician. If you have had a prior mammogram, your primary care provider will have a report on record that would indicate your breast density, or
  • Speak with your mammography provider. If you have had a prior mammogram, your mammography provider will have a report on record that would indicate your breast density.
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How is 3D Mammography/Tomosynthesis Different from Digital (2D) Mammography?

A 3D mammogram exam is very similar to a digital (2D) mammogram—both are performed together on the same mammography unit. Just as with a digital mammogram, the technologist will position you, compress your breast under a paddle, and take images from different angles.

During the 3D portion of the exam, the x-ray arm of the machine makes a quick arc over the breast, taking a series of breast images at a number of angles. The entire procedure should take approximately the same amount of time as a 2D mammogram.

The technologist sends your breast images electronically to the radiologist, who will examine breast tissue one layer at a time instead of viewing all the complexities of your breast tissue in a flat image. Fine details can be more clearly visible, less likely to be hidden by the tissue above and below.

The left image depicts the tomosynthesis experience from the patient's point of view. A 3D mammogram exam is very similar to a digital (2D) mammogram. In fact, both images are taken at the same time, on the same scanner. And just as with a digital (2D) mammogram, the technologist positions the patient, compresses their breast under a paddle and takes images from different angles. During the 3D portion of the exam, the machine's x-ray arm makes a quick arc over the breast, taking a series of images at a number of angles. Tomosynthesis adds no time to the exam, with the entire procedure taking approximately the same amount of time as that of a digital (2D) mammogram.

The right image illustrates the differences in digital (2D) and 3D breast imaging. In the "conventional" digital (2D) mammogram (pictured left), there is an apparent area of concern that may require additional studies, like another mammogram or a biopsy. Instead, looking at the same breast tissue in a succession of 3D images (pictured right), doctors can now see that the tissue is, in fact, normal breast tissue that was simply overlapping in the traditional mammogram, thus creating the illusion of an abnormality. In this scenario, the patient likely avoided a callback for an additional mammogram—and the anxiety that goes along with it—thanks to tomosynthesis technology.
(source: www.healthmanagement.org)
 

 

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Is 3D Mammography/Tomosynthesis Better?

All women may benefit from tomosynthesis; however, the benefit is greatest in women with dense breast tissue, because dense tissue can mask cancers and/or lead to false positives.

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Does Utilizing 3D Mammography/Tomosynthesis Mean I Won't Be Called Back for Additional Views?

3D mammography can help radiologists rule out abnormalities that may have looked suspicious in a digital (2D) mammogram, so the likelihood you'll be called back may be less. However, there is still a chance that some patients will require additional mammographic views and/or ultrasound.

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Is 3D Mammography/Tomosynthesis Covered by Insurance?

Because this technology is so new, insurance may not cover the 3D portion of the mammogram. However, the digital (2D) portion of the exam will be billed to your insurance, which is usually covered at 100% by most plans.

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What is the Cost?

It depends on your insurance carrier.  Should the 3D portion not be covered by your insurance plan, there may be an out-of-pocket cost of $120. This fee helps offset the cost of this new technology and includes the radiologist's interpretation of the additional 3D imaging. Please contact your insurance carrier to verify coverage.

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Is There More Radiation?

The radiation dose is slightly more with 3D/ tomosynthesis as it is for digital (2D) mammography. The combined dose is still below the FDA-regulated limit for digital (2D) mammography and has been found by the FDA to be safe and effective for patient use.

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Can I Add on the 3D Imaging After My Digital (2D) Mammography is Complete?

No. The 3D images must be acquired at the same time as the digital (2D) images.

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Do I Need a Doctor’s Referral?

If you are age 40 or older with no new breast concerns (lump, bump, etc.), you can schedule a mammogram on your own, anytime. While a referral is not required, please talk to your physician or mammography provider if you'd like to add it to your mammogram.

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Where Can I Get This Exam?

We perform Screening 3D Mammography/Tomosynthesis at one of our 10 office locations:

We can typically accommodate screening mammography appointments within one to two business days; however, due to the high demand for tomosynthesis exams, you may experience a longer delay in obtaining your desired appointment date.

To schedule an appointment, call (860) 291-6569.

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Where Can I Get Additional Information?

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