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New study reveals 3-D mammograms are more accurate than 2-D mammograms in detecting breast cancer. Is the difference worth the additional cost? You decide.

Reuters reports on 3D mammograms.  What types of mammograms do you usually get and how often? A new study shows that the best way to test for breast cancer is via 3D mammograms.

The study shows that coupling digital mammography with a 3D technique helps a doctors’ ability to identify breast cancers. It can also lower the need for additional testing which can be nerve wrecking and emotional.

The 3D imagining technique is called tomosynthesis. Here is how it works- instead of applying a two dimensional or flat image similar to a digital mammography machine, tomosynthesis works to create a three dimensional image. This image helps healthcare workers analyze breast tissue from various different angles so that they have can give a more in depth evaluation when trying to find invasive tumors.

Are there any drawbacks to 3D imaging?

Well this technique is said to use more radiation than 2D imaging; but researchers say the level of radiation being used is still quite safe and should not pose any extra health hazard.

How was the study conducted?

Reuters explains, “The researchers analyzed data from 13 hospitals. They compared outcomes for women who were screened for breast cancer during the year before tomosynthesis was introduced at each center to outcomes for those screened after the technique was put in place. Overall, they had information on 281,187 breast exams without tomosynthesis and 173,663 with it. After the 3-D technique was added, 16 fewer women were asked back for additional screening per 1,000 breast exams. Women who had breast exams with tomosynthesis were more likely to get biopsies, but those biopsies were more likely to result in a cancer diagnosis. Roughly one extra cancer was detected for every 1,000 breast exams done using tomosynthesis, the researchers calculated.”

Researchers were ecstatic about the results. Dr. Friedewald, the study’s lead author, told Reuters, “We’re detecting more invasive cancers while calling fewer women back for additional imaging. It’s a more accurate exam. It’s a more accurate picture of what’s going on with the breast. I think this is enough to show that 3-D (imaging) is better than 2-D (imaging).”

ABC news is also endorsing 3D mammography following the results of Dr. Friedewald’s study. “The 3-D scan combo detected one additional cancer per 1,000 scans, compared with conventional digital mammograms. There were also 15 percent fewer false alarms — meaning fewer initially suspicious scan results that additional testing showed wasn't cancer. Standard mammograms typically take one image of each breast from two positions, while 3-D scans take several images of different layers of each breast. That allows for the detection of tumors that might be hidden under breast tissue and not noticeable on regular images. The detection rates were about four cancers per 1,000 conventional scans versus about five cancers per 1,000 combined 3-D scans.”

Is 3D testing more painful? Researchers say no, not at all. In fact most patients, if not all, probably will not even notice a difference between 2D and 3D testing. In both situations the breast is compressed in the same way.

How much does it cost?

“A digital mammogram costs between $200 and $300, but is covered by insurance for most women without a co-pay. The addition of tomosynthesis can add an extra $100 or more to the bill, which is not typically covered by insurance,” according to Reuters.

Should hospitals around the country be scrambling to get 3D imaging machines? Well considering the heightened level of accuracy of this technique most patients will prefer it to 2D imaging. If there is something better out there then why not use it? Especially for a health issue such as breast cancer, which is considered to be one of the leading causes of death of women in the United States.

Has it been proven to save the life of anyone yet? Yes.

Time magazine reports that high-tech 3D imaging saved this woman's life. Time says they are endorsing the new test because it can detect more cancers with fewer false positives.

Time explains how 3D imaging saved one woman’s life, “Lori is a convert. The 55 year old occupational therapist had been told by many mammogram technicians that her breasts were hard to image. Her fibrocystic tissue meant that every mammography report was somewhat less than reassuring. ‘They would say, ‘It doesn’t’ look like anything is there, but just come back in a year, and we’ll keep an eye on it.’ Worried that the mammograms were not picking up on possible cancers, Safer went to University of Pennsylvania, where the breast-imaging center was testing a 3D mammogram.

Building on the 2D technology, the 3D version simply slices the images of the breast and reconstructs them on a computer in 3D form, allowing doctors to get a better view of the entire breast and any potential tumors growing within. Sure enough, the 3D test picked up a suspicious lump. She got a biopsy, and even that was negative, but because the 3D mammogram had detected a potential tumor, doctors recommended she have a lumpectomy to remove the growth. It turned out to be malignant. But because the cancer was picked up in its earliest stages, before any cancer cells could spread to the lymph nodes, Safer is now cancer-free. ‘If I had waited a year, like I would have if I had been getting the regular mammogram, it could be a totally different story’ she says.”

Time states that this study is a much-needed advancement for many breast cancer specialists who wanted a more accurate test. The Food and Drug Administration first approved of 3D mammogram machines back in 2011.

But why are these machines so much better than 2D machines?

Time says 3D machines have an important distinction, “Compared to the 2D mammograms alone, the tomosynthesis improved detection of invasive cancers by 41%, while not increasing rates of picking up DCIS cancers, which don’t spread from the milk ducts and have higher survival rates. That’s important because other technologies, including ultrasound and MRI, led to higher rates of detecting all types of growths, but it’s more important to identify early-stage invasive cancers because treating them can lead to higher remission rates and longer survival.”

Dr. Emily Conant, professor or radiology and chief of breast imaging at the University of Pennsylvania Perelman School of Medicine and one of the study’s co-authors, told Time, “In my long career, this is the biggest improvement in screening I have seen. This is much bigger than the improvement in going from analog or film to digital; I don’t think there’s a doubt about that. Other screening modalities [such as ultrasound and MRI] have shown that they can pick up additional cancers but none have simultaneously reduced the number of recalls. Fewer recalls can lead to fewer risks, and costs, for women.”

CBS news is also advocating 3D imaging after this new study's findings, particularly because of the reduction in callback rates that 3D imaging provides. CBS explains, “A ‘callback’ happens when a mammogram picks up something suspicious, and the doctor wants to do additional imaging or a biopsy. For most women, it turns out to be nothing; according to the American Cancer Society, fewer than 10 percent of women called back for more testing are diagnosed with breast cancer. If 3D mammography can reduce those callbacks, that's a pretty big deal. Additional tests can be anxiety-provoking for women, and they use up time and resources.”

Some women are called back as many as six or seven times to get further tests done when doctors cannot read their images. Not only does this affect them financially and take away time from their every day lives but also puts massive psychological stress on them. Three-dimensional imaging showed, “Detection of more-advanced, ‘invasive’ cancers went up 41 percent. That suggests it's finding more important cancers,” according to CBS.

What happens next? Researchers are now going to look into how often women should be screened with 3D techniques. One slight problem is the fact that some insurers do not cover 3D imaging and it is slightly more expensive than 2D imaging. Time reports on this issue, “The researchers hope that that results will convince more insurers to cover 3D imaging on the premise that despite its higher upfront cost, the test’s sensitivity in detecting invasive cancers would lead to cost savings by avoiding costly follow ups and additional testing.” Overall 3D testing is considered the better choice and worth the higher cost; most experts are saying one should not put a price on their health and wellness, especially if they have the means to afford 3D testing