New 3-D breast exams give doctors clearer view

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It’s taking radiologists’ eyes into deeper territory. New technology boosts 2-D images to 3-D, giving doctors a clearer view, and patients more peace of mind.

Dr. Shilpa Mehta, Director of Mammography at the Breast Care Center, St. Alexius Medical Center: “The digital mammogram has been the gold standard and the reason for that is it’s very good at detecting calcifications, which is the earliest stage of breast cancer.”

And it can spot nodules a woman may not feel on self exam. Still, some patients pose a challenge to radiologists.

Dr. Shilpa Mehta: “When there is more tissue within the breast, such as in a woman with dense breasts, a lesion could easily be hiding in there.”

That’s what makes Dr. Shilpa Mehta’s job so tricky. Like her peers, the St. Alexius radiologist relies on conventional digital images, which provide a single projection of the breast — at a single depth. Now she’s layering in a new technology — 3-D tomosynthesis.

Dr. Mehta: “What 3-D tomosynthesis does is it takes the machine that would just do the single click and actually has it do several clicks as it rotates around the breasts.”

In a single swoop, the arm of the mammography machine captures not one, but multiple pictures at varying depths. Next, computer software stacks the images, each representing a one-millimeter slice of tissue. Radiologists then scroll through the layers, peering deep into the breast.

Dr. Mehta: “Different parts of the breast come into very good focus as I scroll thru and the reason they come into very good focus is you don’t have the tissues behind it or ahead of it obscuring it

Dr. Mehta uses the technology as a supplement to conventional digital mammography. Side-by-side the scans don’t look dramatically different. The difference is in the definition.

Dr. Mehta: “It is defined so much better. There is no tissue around it that is obscuring its margins. It has very nice smooth margins and you automatically lean toward a benign diagnosis. Most likely you would not be sending them for additional biopsy.”

That’s the goal of 3-D imaging, to reduce the need for needle biopsies, even ultrasounds — tests that cause anxiety for patients. Dr. Mehta says the technology is promising.

Dr. Mehta: “Studies have reported anywhere from a 40 to 50 percent reduction in the rate at which patients are recalled from a screening exam for additional testing.”

Three-dimensional breast imaging costs about $100 more than standard mammography, and not all insurance companies cover the new technology. if you’d like to learn more, go to

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