"Should I get a 3D mammogram?" Every day my patients ask me this question. And my answer is always the same - absolutely! 3D mammography, also known as digital breast tomosynthesis (DBT), provides more information about your breasts than a 2D mammogram. Instead of a single flat image, 3D mammography produces multiple thin overlapping slices, allowing the radiologist to scan through the entire breast in greater detail.
The information provided is unquestionably better! Why is it better? To put it simply, breast tissue appears white on a mammogram. When you have a lot of overlapping breast tissue, it can become very difficult to look for cancer, which is also white. So with a 2D mammogram, we often have trouble distinguishing normal tissue from something that we think might be abnormal.
Often the things we call abnormal end up just being normal overlapping breast tissue. Unfortunately, these false alarms can leave a trail of anxiety, inconvenience, and extra costs. With 3D mammography, the false alarms are cut by about 40 percent since the radiologist is better able to see the breast tissue layer by layer. Even more important is that 3D mammography makes us better at finding breast cancer. Cancers are detected at a rate of up to 40 percent higher with 3D mammography compared with 2D mammography alone.
Cancers can be detected at earlier stages, potentially saving more lives. But it is important to keep in mind that 3D mammography does not guarantee that cancers will always be detected without additional tests. Many women, particular women with dense breasts and other risk factors, will need other tests such as ultrasound and MRI. Radiation dose has been a big concern for many women considering 3D mammography.
When using 3D mammography in combination with 2D mammography, the radiation dose is essentially doubled. While the dose is still well below acceptable limits, it can understandably be concerning for women who wish to minimize radiation exposure. The good news is that we now have new tools to help with this! A new technique called C-view allows the total radiation dose for 3D mammography to stay the same as 2D mammography.
So if you are planning on getting a 3D mammogram and are concerned about radiation, consult with the facility about using C-view in place of 2D mammography. As you can see, 3D mammography really does have an advantage over 2D mammography but there is one issue that can really influence your decision, and that is cost! While Medicare pays for tomosynthesis, many private insurers don't.
And even if your insurance covers you, a deductible could still apply. So be sure to check yours with the facility and with the insurance provider on potential out of pocket costs. While there is no perfect imaging tool for breast cancer screening, 3D mammography is taking off like a storm. If you have the option to get a 3D mammogram, then I do encourage it!
About the Author
Dr. Mala Shah, Montclair Radiology www.MontclairRadiology.com earned a BA Degree from Muhlenberg College and studied Fine Arts at the Umbra Institute in Italy. She went on to earn her Doctor of Medicine Degree from Drexel University College of Medicine. She started at Hahnemann University Hospital for her internship, then moved on to Lenox Hill Hospital for residency in Diagnostic Radiology. After completing a fellowship in Breast Imaging at the Mount Sinai Medical Center in New York, Dr. Shah joined Montclair Radiology's Breast Imaging team.
Dr. Shah is board certified in Diagnostic Radiology by the American Board of Radiology. She is also an active member of the Society of Breast Imaging, the American College of Radiology, the Radiological Society of North America, the American Roentgen Ray Society, and the American Association of Physicians of Indian Origin.
