Should You Go 3D for Mammogram Screening?

Monjari Gillian, MD is a diagnostic radiologist at Inova Schar Cancer Institute.

The research is clear: Annual breast cancer screening with mammography can reduce deaths from breast cancer by up to 40 percent. Even more good news: With the increasing availability of 3D tomosynthesis (3D mammography), breast cancer is detected earlier at its most treatable stage.

3D Mammography Explained

A standard 2D mammogram takes two images of the breast (side-to-side and top-to-bottom) and creates a two-dimensional image. In contrast, a 3D mammogram snaps multiple images from different angles and creates a three-dimensional picture. This visual reconstruction of the breast allows radiologists to see through dense tissue and clearly view areas of the breast that are often hard to see in 2D.

The Benefits

1. 3D mammography has a higher cancer detection rate than other breast imaging, including 2D mammography, breast ultrasound and breast magnetic resonance imaging (MRI).
2. Using 3D mammography decreases additional testing by 30- 40 percent compared to 2D mammography.
3. Stress and anxiety often experienced by patients is reduced due to the more accurate and precise results produced by 3D mammography.

The Drawbacks

1. Though the overall radiation dose is low, 3D mammography delivers a higher radiation dose than 2D mammography.
2. 3D mammography is a more expensive imaging option. Not only is the equipment more expensive for radiology groups and hospitals than standard 2D machines, reviewing the images requires more time. Radiologists review up to 100 images in one 3D exam.
3. Insurance doesn’t always cover 3D mammography.

The Big Picture

Under current guidelines, the choice about whether or not to pursue 3D mammography is up to the patient and referring physician. But women who have dense breasts or who are at high risk of developing breast cancer due to a prior history, family history or a known genetic mutation have the most to gain from going 3D.

In those cases, breast cancer experts often recommend some form of screening every 6 months. Usually, physicians suggest alternating traditional or 3D mammography with breast magnetic resonance imaging (MRI) every six months, so radiologists can assess both the anatomy and physiology of the breast tissue.

No matter which type of breast imaging you choose, make sure to schedule an annual screening exam if you’re over 40. Catching cancer early outweighs any downsides of screening – mammograms save lives.

Discover how Inova Schar Cancer Institute tackles breast cancer.