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Do I need a 3-D mammogram?

What breast tomosynthesis is and what to expect


Whether you’ve had a mammogram previously or just turned 40 and want to think through your options for annual screenings, you should consider 3-D mammography, also called digital breast tomosynthesis.

Dr. Nicole Abinanti, a radiologist with Mecklenburg Radiology Associates and director of women’s imaging for the Novant Health Breast Center in Charlotte, North Carolina, provided insight about how 3-D mammography works, and also dispelled common mammogram myths and detailed what to expect during your mammogram.

What it is

The 3-D mammography technology allows a woman’s breast to be imaged from multiple angles. The angled images provide 1-millimeter-thin snapshots of the breast tissue that, collectively, provide radiologists a more detailed, three-dimensional view than standard two-dimensional mammograms.

Better angles and a clearer view help with a more accurate diagnosis. “We are able to better detect potential problems that may be hidden from sight by overlapping normal tissues,” said Abinanti, a radiologist with Mecklenburg Radiology Associates and director of women’s imaging for the Novant Health Breast Center in Charlotte, North Carolina.

What to expect

Most women wouldn’t notice much difference between a 3-D mammogram and a standard digital mammogram. “The examination itself is almost identical for patients,” Abinanti said. “It just takes about four seconds longer per view.”

During a 3-D mammogram, an X-ray tube moves in an arc over the patient and takes multiple low-dose images that are regenerated by a computer. After 3-D imaging is complete, the machine will move back to the center and take the regular two-dimensional, or standard, mammogram pictures.

Why you might need one

Women who would most greatly benefit from tomosynthesis or 3-D mammography are those with dense breasts and those who have an increased risk of breast cancer.

Contrary to popular belief, what constitutes “dense breasts” has nothing to do with breast size. Breast tissue is made of both fatty tissue and glandular tissue, the latter of which causes the density.

“A lot of women come in thinking they have dense breasts but they don’t,” Abinanti said. “Women of all ages may have dense breasts, but we often find that younger women who are premenopausal, or under age 50, as well as thinner women with less fatty tissue have dense breasts.”

However, Abinanti said that all women may benefit from a 3-D mammogram, as it has been shown to increase the cancer detection rate while decreasing callback rates and minimizing overdiagnosis. Detecting cancer early has known benefits, Abinanti added, including the possibility of less-expensive, less-invasive treatments that are usually less disfiguring for a patient.

How to prepare

Abinanti advised having your mammogram done the week after your menstrual cycle. Before your screening, limit caffeine and smoking. Do not wear deodorant or other creams on the day of your mammogram because they can lead to false positives, and take pain relievers if you tend to feel discomfort from the compression.

If you experience pain during the exam, let your technologist know so he or she can adjust appropriately.

Contrary to popular belief, you do not need to have a traditional 2-D mammogram before you can receive a 3-D mammogram. The additional view of the 3-D mammogram is performed at the same time as the traditional mammogram.

And don’t worry. Abinanti dispelled common myths that the radiation exposure or compression used are harmful. “Mammograms do not cause breast cancer or trauma to the breasts,” she said.

“Compression is very important because it actually decreases the radiation dose. A lot of women don’t know that.”

Patients can usually expect to receive their mammogram results in the mail within two weeks of their examination if the examination is normal. Even with 3-D mammography, there are still some findings that require additional imaging or an ultrasound.

Visit NovantHealth.org/pink to schedule your mammogram appointment. Same-day and walk-in appointments are available as well. If you think 3-D mammography is appropriate for you, simply request it when you call. Depending on your insurance plan, additional fees may apply.

For a list of Novant Health locations that offer 3-D mammograms, click here.





Published: 6/1/2016