​Caren Greenstein, MD, director of Breast Imaging at White Plains Hospital, shares her insight and expertise.
What are the advantages of 3D mammography?
It’s a new technology that has demonstrated improvement in the sensitivity and specificity of the mammogram. Studies show that 3D makes mammography better, detecting more cancer and resulting in fewer false positives. Many women choose 3D when available. At some point, it may replace 2D mammography altogether.
What are the key differences between traditional and 3D mammography?
Traditional 2D mammography, which involves an X-ray of the breast, is the standard screening tool used to detect breast cancer in the early stages. Mammography can detect breast cancer several years before tumors can be felt in an exam.
During 3D mammography, the X-ray arm sweeps in a slight arc over the breast, taking multiple breast images. Then, a computer produces a 3D image of the breast tissue in one-millimeter slices, providing greater visibility for the radiologist to see breast detail in a way never before possible.
Is 3D mammography used instead of or in addition to 2D?
It’s usually done in conjunction with 2D mammography.
What’s the difference in radiation exposure?
Although 3D mammography gives approximately the same small radiation dose as 2D, when it’s done in conjunction with 2D, there is an additional small amount of radiation. Therefore, the decision can be made on case-by-case basis by the patient and her clinician.
For women whose doctors have recommended ultrasounds in addition to mammography, does 3D mammography eliminate the need for the two tests?
No! Mammography, whether done in 2D or 3D, uses radiation to depict the radiodensity of a structure. Ultrasound uses sound waves to depict a structure’s echogenicity. Breast cancer has many subtypes, with differing features. A breast cancer may be invisible on 2D or 3D mammography but seen on ultrasound, or seen on mammography but invisible on ultrasound.
If a traditional mammogram is ordered, can a woman request 3D, and will that affect her insurance coverage?
Yes, a woman may request a 3D mammogram at the time of her exam. Though FDA-approved, 3D mammography is still a new technology. Many health-insurance companies cover 3D mammography, but some do not. Some centers charge a minimal additional fee if your insurance doesn’t cover the 3D part of the exam.
What is your best advice for prevention and detection of breast cancer?
It’s proven that early detection saves lives, so follow the guidelines and get screened for breast cancer. Also, maintaining a healthy diet, following a regular exercise routine, and avoiding smoking and excessive alcohol consumption are positive, preventative measures for all cancers.
