Mammography vs Tomosynthesis

The latest 3-D Mammogram, called Digital Breast Tomosynthesis, for Breast Cancer Screening

Breast imagers around the world are beginning to use digital breast tomosynthesis, or DBT, to perform three-dimensional mammography for breast cancer screening and diagnosis.

The DBT system uses a digital x-ray that records a series of low-dose, high-resolution images of the breast while traversing a small (15°) arc around the compressed breast. As the projection angle changes, images are recorded at slightly different depths and thicknesses, from one surface of the breast to the other. Both mammography and DBT need a similar (about 4 seconds) compression time.

Each DBT image can be magnified or manipulated to better reveal tiny details and reveal more accurate interpretations of breast changes.  Radiologists are excited because DBT offers images with a clarity and degree of detail substantial enough to reduce some of the false-positives and false-negatives associated with 2-D mammographic imaging. In small series studies, researchers have reported reducing the false-positive callback rate by as much as 30-40%.

There are some drawbacks to DBT:

  • The approved indications for DBT state that it must be used as an adjunct to standard digital mammography. This means that the radiation dose for women having DBT is slightly higher than it would be with standard digital mammography. Even with the addition of DBT, however, the dose remains lower than the maximum allowed with older, analog mammography.
  • Because DBT is a new platform, techniques for best use are still evolving.  Various studies are being carried out to determine whether the dose of DBT can be reduced without losing image integrity.
  • To date, no substantial trials of DBT have been performed in the U.S., though a large trial is currently being planned. A large-scale population-based study is ongoing in Europe. These trials are very hard to do, and must involve many thousands of women to show a significant benefit in cancer detection of tomosynthesis over routine mammography.

Now if they’d just create a device that didn’t squish us to bits!  Actually there is one – thermal imaging.  See my article on thermal imaging screening – (my preferred method).

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