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Katie Hill
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In a recent blind survey, Solis Mammography – the nation's largest independent provider of breast imaging services – discovered that many women do not know, nor do their primary care physicians advise on, the differences between traditional 2-D mammography and today’s more advanced 3-D mammography (also known as breast tomosynthesis).

In honor of National Women’s Health Week – May 14-20, Solis Mammography wants to demystify 3-D mammography. Also known as digital breast tomosynthesis, 3-D mammography is the best and most advanced technology for early detection of breast cancer. Studies have shown 3-D mammography increases specificity of findings, increasing cancer detection by 54 percent, and lowering unnecessary recalls by up to 37 percent, saving a woman time, money, and unnecessary stress. From a health perspective, early detection increases not just survival rates, but quality of life. The earlier a mass is detected, the more options a woman has for treatment, leading to less aggressive, less expensive and better outcomes.

“3-D mammography is the most significant breakthrough in screening for breast cancer in my lifetime,” said Dr. Stephen Rose, Solis Mammography’s chief medical officer. “This technology helps us every day find smaller cancers earlier while at the same time disrupting fewer lives with call backs. Another significant advantage is the impact this improved screening has on encouraging women in their 40s to get their yearly mammograms.”

3-D Mammography History

The technology of 3-D mammography has been around for nearly a decade. In 2010, Dr. Rose presented the very first patient in the country diagnosed with 3-D mammography to a Food and Drug Administration medical panel. The following year, in 2011, the FDA approved 3-D mammography. Peer-reviewed research, co-authored by Dr. Rose, published in the American Journal of Roentgenology in 2013 demonstrated that 3-D mammography increases early detection of breast cancer by 54 percent and decreases recall rates by 37 percent.In 2015, Medicare announced full coverage for 3-D mammography, and in 2016, CIGNA became the first national private insurer to cover 3-D mammography. Since then, various private insurers have followed suit and many states have passed legislation requiring 3-D to be covered by all private insurers.

How 3-D Mammography Works

From a patient’s point of view, there is no noticeable difference between a 2-D exam and a 3-D exam.  The procedure takes the same amount of time, compression and positioning. The only change a woman will see is that instead of the camera arm of the machine remaining stationary, as in a 2-D mammogram, the arm will swing around the breast as it takes the multiple 3-D images.

From a radiologist’s point of view, the difference in images is night and day. Providing the equivalent of 60 images of breast tissue, divided into 1-mm slices, 3-D mammography allows the radiologist to see cancers as early as stage zero and to find masses that might otherwise be hidden within dense breast tissue. This compares to conventional 2-D mammography that offers the radiologist just two images of each breast through compressed breast tissue.

In layman’s terms, imagine a closed book with clear covers and pages. With 2-D, the radiologist must peer through the front or back cover, looking for a single word that does not have the same characteristics as the other words. With 3-D, the breast becomes like an open book – with the 60 images giving the radiologist an ability to look for that abnormal word one “page” at a time. 

Dense Breast Tissue

Women who have denser breast tissue tend to be younger. Of the women diagnosed with invasive breast cancer in 2015, 22 percent were under the age of 50.

Mammogram images are black and white. Breast cancer and dense glandular tissue appear white, while fatty tissue appears gray on a mammogram. Radiologists can better differentiate cancer from overlying glandular tissue with 3-D mammography.

Additionally, medical research shows that annual mammograms (2-D and 3-D) for women between the ages of 40 and 64 are key to early detection. However, 3-D mammography increases the detection rate by 54 percent. The average size of an anomaly found in a woman who gets regular annual mammograms is the size of a pea versus the average size of an anomaly found by a woman doing self-breast exams, which is the size of a walnut. The advantages of early detection include the possibility of avoiding chemotherapy, radiation, surgery or other invasive treatments.

“While we don’t want to discredit the benefits of getting any mammogram (2-D mammography is significantly better than getting no mammogram at all), we also want women to understand their choices and to know all the benefits of 3-D when choosing what’s best for them personally,” said James Polfreman, CEO and president of Solis Mammography. He continued, “At Solis Mammography, we believe an educated woman is an empowered woman, and we want her to be able to make an informed decision on which type of mammogram is best suited for her. We cannot overstress that early detection is key.”

Polfreman continues, “Furthermore, we are championing insurance legislation change requiring all private insurers to cover 3-D mammography just as they do 2-D mammography.” Currently, Connecticut, New York, Pennsylvania, Illinois, and Arkansas have legislation in place for insurers to treat all screening mammography (2-D and 3-D) the same – at no extra cost to patients.

Solis Mammography believes that 3-D mammography technology, combined with the specialized expertise of radiologists who are sub-specialists in breast imaging, provides women with the peace of mind they deserve concerning their breast health. To that end, Solis Mammography’s commitment to 3-D technology has translated to $18 million invested over the past three years to upgrade all of its centers to provide 3-D mammography.

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