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North Valley Hospital

Tomosynthesis: 3-D Mammography Imaging

NVH Foundation Patient and Family
Women in pink This project is the primary focus of fundraising for the 2017-2018 fiscal year. The Board of Directors of the NVH Foundation have approved the project with a goal of raising $500,000 by December 31, 2017. The project is endorsed and is being championed by Dr. Melissa Hulvat of the Bass Breast Center and Dr. Amanda Beer of Northwest Imaging. The project will fund the purchase of a Hologic 3-D mammography unit. A naming opportunity for the room/machine at $200,000.

Breast cancer is the second most common cause of death from cancer among American women, claiming nearly 41,000 lives a year. Annual mammograms starting at age 40 have long been considered standard for preventive care, because cancer is easier to treat if detected early (www.medicalexpress.com, April 2015).

Three-dimensional mammography (also called tomosynthesis) creates a 3-D picture of the breast using X-rays. Several low-dose images from different angles around the breast are used to create the 3-D picture. Digital tomosynthesis of the breast is different from a standard mammogram in the same way a CT (computerized tomography) scan of the chest is different from a standard chest X-ray. Or think of the difference between a ball and a circle. One is three-dimensional; the other is flat.
  • Several studies have found that 3-D mammograms find more cancers than traditional 2-D mammograms and can reduce the number of false positives and callbacks for patients by 40 percent (JAMA, June 2014).
  • A false positive is when a mammogram shows an abnormal area that looks like a cancer but turns out to be normal. Ultimately, the news is good: no breast cancer. But the suspicious area usually requires follow-up with more than one doctor, extra tests and extra procedures, including a possible biopsy. There are psychological, physical and economic costs that come with a false positive.
Important results from a study involved 454,850 screenings really make the case for 3-D breast imaging: 281,187 women were studied with digital mammography alone and 173,663 who combined it with tomosynthesis. The exams were done from March 2010 through December 2012 (JAMA, June 25, 2014).
  • Tomosynthesis improved cancer detection. Cancer was found in 4.2 of every 1,000 scans with digital mammography alone, but in 5.4 when tomosynthesis was added.
  • With digital mammography alone, 4.3 percent of the women called back turned out to have cancer, but the rate was 6.4 with the tests combined.
  • Performance improved with tomosynthesis: Combined testing found 4.1 invasive cancers per 1,000 scans, whereas digital mammography alone found 2.9.