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February is Cancer Prevention Awareness Month. Here at the Abramson Cancer Center, we are committed to providing outstanding comprehensive cancer care and cancer information including ways to prevent cancer. Further, cancer researchers at Penn are at the forefront of learning new ways to prevent and detect cancer.

In this article, we discuss mammograms. And how a new type of mammogram offered at Penn may improve accuracy.

The mammogram remains the most important screening device in the detection of breast cancer and it likely saves thousands of lives every year.

Beginning at the age of 40, all women should have an annual mammogram to check for breast cancer. Depending on a woman’s personal risk, her physician may recommend she begin annual mammograms before the age of 40.

A revolutionary way to perform mammograms combining traditional mammography with 3D technology, called digital breast tomosynthesis (DBT), allows for more accurate pictures of breast health.

Like traditional mammogram, the breast is compressed for about four to five seconds while a series of low-dose X-rays are taken to capture high-resolution images of the breast. These images are then digitally “stacked” to construct a total 3D image of the breast. This 3D image allows radiologists to scroll through, and “peel apart” the layers of the breast to view the breast tissue at different depths and angles. Radiologists can also magnify images to reveal minute details.

Women who get their mammograms using the new DBT technology may find they are called less often for follow-up visits and more tests.

Learn more about DBT at Penn, and how you can schedule your DBT mammogram at Penn.

Penn researchers participated in the recently published study entitled: "Breast Cancer Screening Using Tomosynthesis in Combination with Digital Mammography," which reviewed almost half a million mammography exams. The study, published in the June 25, 2014 issue of the Journal of the American Medical Association (JAMA), found that tomosynthesis imaging, or 3D mammography, finds significantly more invasive or lethal cancers than a traditional, 2D mammogram.

3D mammography also reduces the number of women called back for unnecessary screenings; thereby reducing anxiety and health care costs.

Specific improvements with 3D mammography screening in the research found:

• A 41% increase in the detection of invasive breast cancers
• A 29% increase in the detection of all breast cancers

Emily Conant, MD, senior author of the study

• A 15% decrease in women recalled for additional imaging

Digital Breast Tomosynthesis FAQs

What is digital breast tomosynthesis?

Digital breast tomosynthesis, or 3D mammography, is a technique using X-rays to produce a three dimensional picture of the breast. The result or output is a series of image "slices" through the breast that can be viewed as individual pictures. This often clarifies whether a finding is a true abnormality or an overlap of normal structures, and can result in the visualization of abnormalities that would be hard or impossible to see, otherwise. Standard, or 2D mammograms, consist of one picture of the breast in each position, as opposed to many slices. Overlapping breast tissue can make the 2D images difficult to interpret.

How are the 3D images obtained?

The 2D and 3D images for each view of the breast are obtained during a single breast compression. To obtain the 3D images, the X-ray beam swings in an arc, usually after the standard 2D views are obtained. Or, with the newest technology, the 2D images can be reconstructed from the tomosynthesis 3D images, decreasing the required dose. Compression will last for just a few seconds longer than for a standard mammogram without tomosynthesis, but most patients will likely not notice a difference.

Who should get breast tomosynthesis?

Everyone who is a candidate for 2D mammography is also a candidate for tomosynthesis. Patients with dense breast tissue may benefit more from the added modality than those with more fatty breast tissue, but even fatty breasts are better evaluated with tomosynthesis.

What about radiation exposure?

With studies where 2D images are reconstructed from the tomosynthesis images, the dose from the whole (2D and 3D) study is exactly the same as from a 2D-only study. Even for studies where the 2D and 3D images are both obtained, the total dose is still below the limit under the Mammography Quality Standards Act (MQSA) set forth by the FDA.

How do I get a 3D mammogram?

The referring clinician can order it, or the patient can request it at the time of the study.

Will patients be charged?

There is no additional charge to the patient.

For more information about breast cancer diagnosis and treatment at Penn Medicine, or to schedule an appointment, visit PennCancer.org  or call 800.789.PENN (7366).