The newest advance in breast imaging is digital 3D mammography, also known as digital breast tomosynthesis (DBT). Starting in July 2016, all patients will have digital breast tomosynthesis performed with their annual screening mammogram appointment.
3D mammography takes images of each breast from multiple angles with an x-ray machine that moves in a 30-degree arc. It takes less than 10 seconds for the imaging. The result is a detailed picture used to identify the precise location of any tumors or microcalcifications, which are small calcium deposits that are common and usually benign. The x-ray dose for a tomosynthesis image is similar to that of a regular mammogram.
Patients might not notice a difference in how the exam is performed compared with 2D mammography, but the benefits of the new technology are significant. Studies show that 3D mammography offers improved clarity and cancer detection compared with conventional 2D mammography. With the improved clarity, radiologists are able to confirm whether the mammogram is showing a tumor earlier in the screening process.
Initial research has found a 30 to 40 percent reduction in the number of call-backs from screenings and an approximate 10 percent improvement in cancer detection using 3D compared with 2D mammography.
Brigham and Women’s Faulkner Hospital breast imaging specialists are now using 3D mammography to screen women over 40 years of age. Digital 3D mammography is also used in follow-up exams when there has been a suspicious finding on a previous mammogram.
You will be asked to remove all clothing and jewelry above the waist. You will be given a gown to wear. You will be asked to stand in front of a special mammography x-ray machine. The radiology technologist will place the breast between two plastic plates. The technologist will press the breast between the two plates. This compression may be uncomfortable for a few seconds while the x-ray is taken. You will be asked to hold very still, without breathing for a few seconds. The technologist will step behind a radiation barrier and activate the x-ray machine. Immediately after the x-ray is taken the pressure is released. Compression needed for a tomosynthesis exam is usually about the same as that for a regular mammogram. For a mammogram, two x-rays of each breast are taken. For a tomosynthesis scan, the breast will be held in place while a special tube rotates around the breast. This should take about 10 seconds. You will not feel the radiation.
3D mammography/tomosynthesis is a non-invasive way of helping to detect breast cancer.
The risk of radiation from a mammogram is considered minimal and not significant.
Some breast cancers do not show up on mammograms or “hide” in dense breast tissue. A normal (negative) exam is not a guarantee that a woman is cancer-free. When a mammogram appears normal, but cancer is later found the mammogram is called a false negative exam. The false negative rate is estimated to be 15 to 20 percent; higher in younger women and women with dense breasts.
A mammogram may show areas that are considered suspicious or not normal. When this happens, additional testing is usually suggested, such as additional mammograms, ultrasound, MRI imaging or a breast biopsy. When the mammogram shows a suspicious change in the breast but no cancer is found, the mammogram is called a false positive exam. It is estimated that 75 to 80 percent of all breast biopsies resulted in benign results (no cancer is found).
All patients scheduled before 3 pm Monday through Friday will receive a phone call from a staff member later in the same day at a phone number you have identified at the time of your appointment.
You will continue to receive mailed results in addition to a phone call, and results will also appear on Partners Patient Gateway* at some point following your exam (though not necessarily on the same day).
We will preserve a select number of scheduled appointments with “live results” for patients who value meeting with the Radiologist after their exam is completed. If you are scheduled for an upcoming appointment and would like a “live result”, you must act now and call 617-983-7272 to reschedule into an available slot. Otherwise, you will receive your results as described above. If a slot is not immediately available, we recommend you keep your upcoming appointment so as not to delay your mammogram (you will still receive same day notification of results), and schedule your following year appointment into a “live reading” appointment slot during your visit.
*You may access your results electronically through Partners Patient Gateway at some point in the days following your exam. Partners Patient Gateway is a convenient and secure way to receive results, manage your health, and communicate with your doctor's office online. To sign up for an account, go to www.patientgateway.org and click the "Enroll Now" button.
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