3D mammogram latest tool in fight against breast cancer

Article Date: Apr 3, 2013

Lakeside Gets Breakthrough Technology

With almost a quarter of a million women expected to be diagnosed with invasive breast cancer in 2013, Alegent Creighton Health is the only health system in the area to offer the latest screening tool in the fight against breast cancer.

It's the new digital 3D mammogram – called breast tomosynthesis—and it helps physicians detect tumors not revealed in the traditional 2D X-ray.

One new study of more than 12,600 women published in Radiology found a 40 percent increase in the detection or identification of invasive cancers with 3D mammography. There was also a drastic reduction in false positives, so fewer women had to be called back for suspicious-looking findings that turn out to be benign.

"The Next Generation"

"This is probably the next generation in mammography," says Katie Mendlick, M.D. The new technology is available exclusively at Alegent Creighton Health Lakeside Hospital and is part of Alegent Creighton Health's continuum of breast care for women—which includes physician exams, 2D mammograms, MRIs, and gammograms.

3D mammography uses high-powered computing to convert up to 15 digital breast images into a stack of very thin layers or slices—building what is essentially a three-dimensional mammogram. A woman's breast will be under compression while the x-ray arm of the machine makes a quick arc over the breast, taking a series of images at a number of angles.

Radiologists can then examine the breast layer by layer and the tissue a millimeter at a time, instead of from the 2-D mammogram's bird's eye view. Dr. Mendlick says this latest advance in breast care allows doctors to "look in between overlapping tissue" and improve their cancer detection rate. "This means a lot for our patients. It shows Alegent Creighton Health's commitment. We were the first to get it—a leader in the region, especially with regard to breast cancer."

Patients who should consider the 3D technology: (1) those who are high risk and previously had breast cancer; (2) patients with a lump; (3) patients with "dense" breasts, as diagnosed by their physician; and (4) those with a family history of breast cancer.

Under FDA guidelines, the 3D test has to be performed in combination with a 2-D mammogram but Dr. Mendlick says the patient "will not notice a difference" and radiation levels are still safely below the American College of Radiology guidelines. The test is so new Dr.Mendlick says insurance companies do not pick up the cost yet.

At this time it is expect that private healthcare insurance, Nebraska Medicaid and Medicare will not pay the additional fees for the new 3D technology. The patient's insurance will be billed for the traditional digital mammogram, but there may be an additional charge of $75 for adding the 3D tomosynthesis technology.

The testing will be available at Lakeside Hospital beginning in mid-March.

Dr. Mendlick says the technology should reduce the number of "callbacks"—where women have to return for follow-up tests after a suspicious first finding--by 30 to 40 percent. "That takes away a lot of the anxiety."

3D mammography has proven so popular—there are only 140 machines in the United States so far—that Dr. Mendlick says hospitals frequently order a second. She says the nearest 3D equipment is in Des Moines and in St. Louis. "There isn't any one perfect technique but we're getting closer. This is our goal—to detect breast cancer early."

Alegent Creighton Health's Continuum of Care

Dr. Mendlick with the 3D Mammography Machine
Dr. Mendlick with 3D Mammography Machine
Lakeside Hospital had another first in 2006—the first digital 2-D mammogram for Omaha, which has largely replaced screen film. Dr. Mendlick says digital 2-D is considered the "gold standard" today and works well for most women. The American Cancer Society recommends an annual mammogram starting at age 40.

Alegent Creighton Health also offers MRIs for women at high risk (greater than a 20 percent lifetime risk). The American Cancer Society recommends they get an MRI and a mammogram every year. Yearly MRI screening is not recommended for women whose lifetime risk is less than 15 percent. Another technology—the gammogram—is available at Alegent Creighton Health's Midlands Hospital for patients who are newly diagnosed with breast cancer.

All patients in their 20s and 30s are also urged to get a clinical breast examination at least every three years. Beginning in their 20s, women should do breast self-examination once a month, usually about seven to 10 days after the start of their periods. Dr. Mendlick says women who want help learning how to do a self-exam can contact the Lakeside Breast Health Center at (402) 717-8505.

No matter your age or which screening tool you use, doctors agree that early detection is the best defense against breast cancer because it increases a woman's chances of survival. That's why Alegent Creighton Health is adding one more tool to its continuum of breast care.

This article originally appeared in the Alegent Creighton Health enewsletter. Subscribe now and get the latest health and wellness information delivered to your inbox.

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Katie Mendlick, M.D

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